Humza Thobani

All Publications

• How low should we go? Outcomes of ECMO in neonates with low gestational age or birth weight. Pediatric surgery international Khan, F. A., Thobani, H., Neal, D., Islam, S. 2025; 41 (1): 74

  Abstract

  PURPOSE: Initial recommendations for ECMO had relative contraindications for low birth weight (BW) or low gestational age (GA) babies. However, more recent literature has demonstrated improved and acceptable outcomes of ECMO in smaller neonates. The purpose of this study was to understand both utilization and survival in patients with lower GA and BW.METHODS: All neonates captured in the Extracorporeal Life Support Organization (ELSO) registry who underwent a single ECMO run from 2009 to 2019 were included. The primary outcome measure was mortality and the secondary outcome measure was major adverse outcomes, defined as a composite outcome variable any severe ECMO complications. Univariate and multivariable statistical tests were performed to estimate the association between GA and BW with both outcome variables.RESULTS: A total of 14,167 cases met inclusion criteria. Univariate analysis noted that birth weight, gestational age, ECMO mode, pulmonary support type, pH and ventilator settings were highly significant predictors of survival. Multivariable assessment noted significant linear relationship of mortality rates with increasing GA and BW (p<0.001, OR=0.82 GA, 0.51 BW). The highest ECMO-related mortality was observed in neonates with GA 30-31weeks and BW 1.5-2.0kg, with a 70-75% in-hospital mortality rate.CONCLUSIONS: Decreasing GA and BW were strongly correlated with increasing odds of mortality and/or ECMO-related complications. However, even in low GA or BW neonates, survival may be possible in up to a quarter of patients put on ECMO.

  View details for DOI 10.1007/s00383-025-05972-5

  View details for PubMedID 39864029

• Age and Weight Stratified Outcomes of Single Stage Endorectal Pull-through Procedures for Hirschsprung's Disease in Children: Analysis of NSQIP-P Data. Journal of pediatric surgery Thobani, H., Tahan, D., Shah, A. A., Raymond, S. L., Chiu, B., Islam, S., Khan, F. A. 2025: 162168

  Abstract

  We aimed to analyze the effect of age and weight on 30-day outcomes of single-stage endorectal pull tthrough (ERPT) procedures for Hirschsprung's Disease (HD) using the National Surgical Quality Improvement Program-Pediatric (NSQIP-P) database to identify an optimal time for surgery.We queried NSQIP-P for children <2 years with HD who underwent ERPT between 2016-2021 and did not have a preoperative stoma. Patients were stratified by age (<3 months, 3-6 months and >6 months) and weight (<4 kg, 4-8 kg, and >8 kg) at the time of surgery. The primary outcome measure was major adverse outcomes, and the secondary outcomes were 30-day unplanned readmission and reoperation. Multivariable logistic regression was conducted to analyze the association between age and weight and each outcome.A total of 1002 patients were included with a median age of 31 days (IQR: 10-106 days). Patients were stratified by age (n = 702, 70.1 %; n = 158, 15.8 %; n = 142, 14.2 % respectively from youngest to oldest) and weight (n = 472, 47.1 %; n = 421, 42.0 %; n = 109, 10.9 % respectively from lowest to highest weight) groups. On multivariable analysis, age>6 months and weight>8 kg were independently associated with a higher rate of major complications (aOR = 2.741, 95 % C.I. = 1.234-5.880 and aOR = 4.627, 95 % C.I. = 1.761-11.775 respectively). Conversely, being in the highest age (aOR = 0.359, 95 % C.I. = 0.176-0.699) and weight brackets (aOR = 0.396, 95 % C.I. = 0.171-0.801) independently predicted lower 30-day readmission rates.Earlier single-stage ERPT for HD was found to be associated with lower complication rates in a select group of patients but may result in increased rates of readmissions and hospital resource utilization.Level III evidence.Retrospective cohort study.

  View details for DOI 10.1016/j.jpedsurg.2025.162168

  View details for PubMedID 39827080

• How Well Are We Preserving Ovaries in Children and Adolescents? Analysis of NSQIP-Pediatric Data Thobani, H., Islam, S., Khan, F. A. LIPPINCOTT WILLIAMS & WILKINS. 2024: S315-S316

  View details for Web of Science ID 001348680702101

• Home Antibiotic Use after Appendectomy for Complicated Appendicitis Does Not Influence Outcomes in Children Without Postoperative Signs of Infection: A NSQIP-P Observational Study Thobani, H., Nepomuceno, H. L., Schwab, M., Emengo, P., Shah, A. A., Raymond, S., Islam, S., Khan, F. A. LIPPINCOTT WILLIAMS & WILKINS. 2024: S349-S350

  View details for Web of Science ID 001348680702172

• The Optimal Age for Lobectomy of Congenital Pulmonary Airway Malformations in Infants: An Analysis of NSQIP-P Data Thobani, H., Islam, S., Khan, F. A. LIPPINCOTT WILLIAMS & WILKINS. 2024: S363

  View details for Web of Science ID 001348680702199

• Hepatic resections for pediatric hepatoblastoma: analysis of 30-day outcomes using the National Surgical Quality Improvement Program-Pediatric database. Pediatric surgery international Thobani, H., Durrani, R., Raymond, S. L., Shah, A. A., Islam, S., Khan, F. A. 2024; 40 (1): 230

  Abstract

  BACKGROUND: Surgical resection remains the cornerstone of treatment for hepatoblastoma in children and offers the best chance of disease-free survival. We aimed to analyze the 30day outcomes of hepatic resection for hepatoblastoma stratified by extent using the National Surgical Quality Improvement Program-Pediatric (NSQIP-P).METHODS: We queried NSQIP-P for children undergoing resection of Hepatoblastoma from 2012 to 2021. Relevant clinical characteristics and outcomes were extracted for multivariate logistic regression to identify predictors of common adverse outcomes.RESULTS: We included 458 children with a median age of 1.90years. Overall complications were rare, and perioperative blood transfusion (64.2%) and postoperative ventilation>48h (10.0%) were the only adverse events prevalent in more than 5% of patients. Median transfusion volume was 15.7ml/kg. On multivariate regression, only patients undergoing Trisectionectomy (aOR=3.387, 95% C.I.=1.348-8.510) had higher odds of receiving>75th percentile blood transfusion. Furthermore, only perioperative transfusion and postoperative ventilation>48h were statistically more common in patients undergoing extended versus standard resections.CONCLUSIONS: Outcomes following resection of hepatoblastoma are excellent, with low rates of postoperative adverse events. Although children undergoing trisectionectomy likely require greater transfusion volume, extended hepatic resections do not appear to have worse 30day outcomes despite greater operative complexity and duration.

  View details for DOI 10.1007/s00383-024-05820-y

  View details for PubMedID 39154089

• Pancreatic masses in children: a single-center experience over two decades. European journal of pediatrics McRae, J. J., Thobani, H., Sacks, M. A., Raymond, S. L., Shah, A., Radulescu, A., Khan, F. A. 2024

  Abstract

  Pancreatic masses are extremely rare in pediatric patients, with limited data available. This lack of data makes the diagnosis and management of these tumors in children extremely challenging. Therefore, we aimed to describe the presentations, clinical course, and outcomes of children with pancreatic tumors at our center. A retrospective analysis was performed of all pediatric patients diagnosed with pancreatic masses between 2003 and 2022 in an academic freestanding children's hospital. Data including demographics, clinical presentation, workup, management, and subsequent morbidity and mortality were collected and aggregated. Furthermore, we reviewed cases of pancreatic tumor resections in the National Surgical Quality Improvement Program - Pediatric (NSQIP-P) database to identify common adverse outcomes and measures for quality improvement. In total, 17 patients were identified at our institution. Diagnoses included solid pseudopapillary (n = 9), gastrinoma (n = 1), rhabdomyosarcoma (n = 2), pancreatoblastoma (n = 2), and insulinoma (n = 1). Two patients did not have a histopathologic diagnosis and were excluded from subsequent analysis. Overall, 12 patients underwent surgical intervention, with the most common procedures being pancreaticoduodenectomy and distal pancreatectomy, and all 12 were known to be alive at last contact. There were 3 deaths, all due to complications related to metastatic disease. Furthermore, 30-day postoperative outcomes in the NSQIP-P dataset for pancreatic surgeries in pediatric patients are excellent, with negligible morbidity and no mortalities after the index surgery.Children with pancreatic tumors amenable to surgical resection appear to have adequate long-term survival. Short-term outcomes at diagnosis are excellent and mainly appear to be influenced by the presence of metastatic disease at initial presentation.• Pancreatic masses are a rare entity in children with limited data on their presentation, management and surgical outcomes. • Solid Pseudopapillary tumors are one of the most common pancreatic tumors in children with a fair prognosis after surgical intervention.• Surgical management of pediatric patients with pancreatic tumors is safe and effective in patients who do not have aggressive tumor types or metastatic disease. • Our case series provides a notable cohort of these pancreatic tumors with insight into the presentation, management and outcomes of five of these tumor types.

  View details for DOI 10.1007/s00431-024-05731-z

  View details for PubMedID 39145888

  View details for PubMedCentralID 10941481