Staff:

Girolamo Mattioli, Full Professor

Michele Torre, Associate Professor

Research topics:

The SSD of Pediatric Surgery carries out its clinical and research activities at the UOC of Pediatric Surgery at IRCCS Giannina Gaslini. The discipline deals with the surgical treatment of congenital malformations and acquired pathologies in pediatric age, involving different body districts. The surgical approach is mainly minimally invasive and, increasingly, robot-assisted, to reduce invasiveness and improve postoperative outcomes in the pediatric patient.

Chest and Airway

The main pathologies treated include congenital lung malformations (CPAM, pulmonary sequestration, bronchogenic cysts, congenital lobar emphysema), pneumothorax, pleural empyema, and congenital and acquired airway malformations (e.g., tracheomalacia, tracheal stenosis, tracheo-oesophageal fistula). Chest wall abnormalities such as pectus excavatum and carinatum, Poland syndrome, and Jeune syndrome are also treated.

- The main lines of research include:

analysis of the efficacy of cryoanalgesia versus standard treatments in patients operated for pectus excavatum; a multicenter study (in collaboration with the Bambino Gesù Hospital in Rome) on the comparison of Nuss technique and Pectus Up technique; and the efficacy of minimally invasive and robotic treatment for complex tracheal pathologies.

Digestive Surgery

This area includes colo-rectal, hepato-biliary and nutrition surgery. Pathologies treated include: diseases of intestinal innervation (e.g., Hirschsprung's disease, chronic intestinal pseudo-obstruction), chronic inflammatory bowel diseases (Crohn's disease, ulcerative colitis), disorders related to nutrition and gastrointestinal motility (gastroesophageal reflux, delayed gastric emptying, esophageal replacement), intestinal malrotation, biliary malformations, and appendicular pathology.

- Main lines of research include:

colo-rectal surgery, with focus on pathogenetic mechanisms and surgical strategies for visceral myopathies and Hirschsprung's Disease. In this area, the PNRR project “Network to foster preclinical studies in monogenic dominant diseases: the visceral myopathy case” is active; optimization of the surgical approach in inflammatory bowel disease; and analysis of surgical outcomes in nutrition-related diseases, with a focus on innovative techniques of gastro-duodenal diversion and esophago-gastric deconnection.

Pediatric Urology

Treated pathologies include congenital malformations of the urinary tract (CAKUT), vesicoureteral reflux, pyeloureteral joint stenosis, ureterocele, double renal district, and urolithiasis. Andrological issues (varicocele, cryptorchidism), bladder dysfunction (neurogenic/non-neurogenic bladder) and genital abnormalities (hypospadias, epispadias) are also addressed.

- Active research includes:

learning curve analysis in robotic-assisted pyeloplasty; multicenter studies of robotic interventions for complex ureterovesical junction abnormalities; use of indocyanine green to assess intraoperative renal perfusion; assessment of infectious risk associated with the presence of ureteral stents; and a multicenter European study of the efficacy of perioperative antibiotic prophylaxis in pediatric endoscopic procedures.

Oncologic Surgery

Pediatric oncologic surgery treats solid tumors such as neuroblastoma, renal tumors (e.g., Wilms' tumor), rhabdomyosarcomas, and gonadal neoplasms (ovarian and testicular). Gaslini is a national reference center for neuroblastoma, with a focus on minimally invasive and robotic surgery, and the use of Image Defined Risk Factors (IDRFs) to predict surgical complexity. In addition, the group participates in national and international collaborations on the treatment and classification of pediatric rare tumors.

Neonatal Surgery

Includes the surgical management of anorectal malformations, intestinal atresias, diaphragmatic hernias, abdominal wall defects (gastroschisis, omphalocele), necrotizing enterocolitis, meconium ileus, short bowel syndrome, intestinal duplications, pyloric stenosis and esophageal atresia. The activity is oriented toward continuity of care, from the neonatal period to follow-up in the developmental age.

Pediatric Plastic Surgery

Focuses on the treatment of thoracic malformations (e.g., Poland syndrome), breast malformations, and burn outcomes. Research activity is focused on the innovative use of nanofat as regenerative therapy for complex scar outcomes, including esophageal, airway and anal stenosis in patients operated for MAR.

MAIN NATIONAL AND INTERNATIONAL COLLABORATIONS

• Kazakhstan – Mother and Child Medical Center

• INPAT – International Network of Pediatric Airway Teams

• Clinical collaboration with leading National and International Pediatric Surgery Centers

• Participation in the Italian Society of Pediatric Surgery (SICP)

• Participation in the Italian Society of Pediatric Gastroenterology, Hepatology and Nutrition (SIGENP)

• Participation in the European Paediatric Surgeons’ Association (EUPSA)

• Participation in the European Society of Paediatric Endoscopic Surgeons (ESPES)

• Participation in the European Society for Paediatric Urology (ESPU)

• Participation in the International Society of Paediatric Oncology – European Neuroblastoma Group (SIOPEN)

• Participation in the International Society of Paediatric Surgical Oncology (IPSO)

• International missions: Kazakhstan, Iraq, Haiti, Tunisia, Angola

• Collaboration with family support associations