Related Experiment Video
Updated: Oct 19, 2025
Author Spotlight: Advancing Pediatric Epilepsy Surgery in Children Through Novel Biomarkers and Enhanced Localization
Published on: September 20, 2024
A Review of History and Challenges of Evidence-Based Pediatric Surgery
George Vaos1, Anastasia Dimopoulou1, Nick Zavras1
1Department of Pediatric Surgery, School of Medicine, National and Kapodistrian University of Athens, "Attikon" General University Hospital, Haidari, Athens, Greece.
Insights
Evidence-based pediatric surgery (EBPS) faces challenges in conducting randomized controlled trials (RCTs) due to rarity of conditions and surgeon skepticism. Establishing evidence-based centers is crucial for advancing pediatric surgical care.
Area of Science:
- Pediatric Surgery
- Evidence-Based Medicine
Background:
- Evidence-based pediatric surgery (EBPS) integrates best evidence into clinical decisions for pediatric surgical patients.
- This review examines the evolution and current state of evidence-based clinical decision-making in pediatric surgery.
Purpose of the Study:
- To comprehensively review past and present evidence-based clinical decisions in pediatric surgery.
- To identify and analyze the challenges hindering evidence-based practice in pediatric surgery.
Main Methods:
- A systematic literature search was performed using PubMed.
- Included studies were peer-reviewed articles on EBPS published over the last 25 years.
Main Results:
- 145 full-text articles were analyzed.
- Challenges to randomized controlled trials (RCTs) include rare conditions, difficulty in multicenter collaboration, ethical concerns with sham operations, and surgeon reluctance to adopt new findings.
- Surgeons often prefer established personal practices over documented RCT results.
Conclusions:
- RCTs are limited in pediatric surgery due to design, publication issues, and skepticism towards implementation.
- Pediatric surgeons should establish evidence-based centers to improve RCT quality and evaluation.
- This will enhance clinical decision-making and elevate the standard of pediatric surgical care.
Purpose:
Evidence-based pediatric surgery (EBPS) refers to the use of the best available evidence in making personalized decisions concerning the management of each pediatric surgical patient. This study aims to provide a comprehensive review on past and present evidence-based clinical decision, and challenges in pediatric surgery.
Material And Methods:
A literature search was conducted according to a set of criteria in PubMed for historical and current peer-reviewed studies regarding EBPS.
Results:
One hundred forty-five full-text published articles focusing on EPBS findings over the past 25 years were included. The rarity of many congenital anomalies, the inability to establish multicenter collaborations, the failure to perform double-blinded studies in children, the pediatric surgeons' reluctance to perform ethically unacceptable sham operations and their skepticism shown in accepting and implementing the documented results instead of applying their personal clinical practice methods and surgical techniques are among problems that hamper the accomplishment of randomized controlled trials (RCTs).
Conclusions:
RCTs remain limited in clinical pediatric surgery practice due to problems in the design and publication of these trials. Moreover, skepticism exists regarding acceptance and implementation of the documented results of RCTs. Notwithstanding, pediatric surgeons must establish evidence-based centers in order to increase the number of well-designed RCTs, properly evaluate clinical research, make effective evidence-based clinical decisions and develop high-quality of pediatric surgeries care in the future.
Related Concept Videos
01:30Psychosurgery
Historical Development of Psychosurgery
In the 1930s, Portuguese neurologist Antonio Egas Moniz introduced a surgical procedure designed...
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD: