WOFAPS 2025 8th World Congress of Pediatric Surgery

Qiang Shu ¹, Yicheng Xie ², Sumit Dave ³, Augusto Zani ⁴, Dan Poenaru ⁵, Paul D. Losty ⁶, Saleem Islam ⁷, Florian Friedmacher ⁸, Gornelia Griggs ⁹, Priyank Yadav ¹⁰, Anastasia Mentessidou ¹¹, Adirian Chi-Heng Fung ¹², Arimatias Raitio ¹³

¹ Department of Cardiac Surgery, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
² National Clinical Research Center for Child Health, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
³ Department of Surgery and Pediatrics, Western University, Canada
⁴ Department of Surgery, Washington University School of Medicine, Saint Louis, USA; Division of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, Canada
⁵ Faculty of Medicine and Health Sciences, McGill University; Department of Pediatric Surgery, The Montreal Children’s Hospital, Montreal, Canada
⁶ Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK; Department of Pediatric Surgery, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
⁷ Department of Surgery, Aga Khan University Medical College, Karachi, Pakistan
⁸ Department of Pediatric Surgery and Pediatric Urology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, Germany
⁹ Division of Pediatric Surgery, Massachusetts General Hospital, Boston, USA
¹⁰ Department of Urology and Renal Transplantation, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
¹¹ Department of Paediatric Surgery, Cambridge University Hospitals NHS, Cambridge, UK
¹² Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
¹³ Department of Pediatric Surgery and Pediatric Orthopedic Surgery, University of Turku and Turku University Hospital, Turku, Finland

Project Team: This project is led by the Editorial Office and Editorial Board Members under the supervision of Dr. Qiang Shu (Editor-in-Chief, World Journal of Pediatric Surgery, Children's Hospital, Zhejiang University School of Medicine). The author list will expand as additional contributors are recruited.

Background

Systematic reviews and meta-analyses are pivotal for synthesizing evidence to guide clinical practice and policy-making in pediatric surgery (PS). However, existing reporting guidelines, including PRISMA 2020, PRISMA-C for child health, PRISMA-S for surgery, failed to address the unique complexities of pediatric surgical research. Key challenges include age specific considerations, surgical technique, and ethical and long-term follow-up (transition to adult), leading to inconsistent reporting of critical items for pediatric surgical data reuse. This gap impedes the validity and applicability of evidence, hindering clinical decision-making and resource allocation in child health. In order to maximize the transparency, replicability, and quality of such studies, we aim to develop an extension of Preferred Reporting Items for Systematic Reviews and Meta-Analyses in Pediatric Surgery (PRISMA-PedSurg) through this project.

Objectives

1) Develop an updated checklist addressing pediatric surgical specificities.

2) Create a flow diagram for study selection adapted to pediatric populations.

3) Publish an Explanation & Elaboration (E&E) document with examples.

4) Establish international endorsement and implementation strategies.

Methodology

This research project will be conducted in five phases and will adhere to the Enhancing the QUAlity and Transparency Of health Research (EQUATOR) group’s methodology for guideline development. The first phase will consist of the establishment of a project team, including journal editorial board members, methodologies and journal editors. In the second phase, we will conduct literature search to identify existing evidence on quality of reporting systematic reviews and meta-analyses in PS, and generate a preliminary list of PS-specific items that need to be modified or added for application, based on the original 27 items. Next, in phase 3, Delphi survey will be conducted by sending the preliminary list of items to the expert with experience in PS systematic reviews and collect feedback to form a brief list of possible PRISMA-PedSurg extension items. Fourth, an international consensus meeting will be arranged to discuss these items and reach a final checklist required for the extension. Participants for the formal meeting will include the project team, leading experts in SR methodology, representative users of pediatric systematic reviews. In the final phase, the guideline documents will be written by the project team, including a statement and an explanation and elaboration (E&E) document. The PRISMA-PedSurg extension and questionnaire will be introduced to authors of systematic reviews in PS and gather feedback on the usage experience of the PS-specific items.

Conclusion

The PRISMA-PedSurg guidelines will address critical gaps in pediatric surgical research by: 1) enhancing reporting quality; 2) facilitating evidence synthesis; 3) Supporting global equity. By integrating methodological rigor with pediatric surgical priorities, PRISMA-PedSurg will empower researchers, clinicians, and policymakers to improve surgical care for children worldwide. Collaborative endorsement by journals, societies, and funders will ensure widespread adoption and long-term impact.

Ethic Statements:

This protocol was considered a quality improvement project by the Ethics Committee of Children's Hospital, Zhejiang University School of Medicine and therefore did not require ethical review. The resultant checklists are intended to be published concurrently in multiple journals.