Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica最新文献_第7页

Assessment of quality indicators in pediatric major outpatient surgery. Influence of the COVID-19 pandemic. 儿科门诊大手术质量指标评价。COVID-19大流行的影响。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2023-01-01 DOI: 10.54847/cp.2023.01.15

A Ramírez Calazans, R M Paredes Esteban, O B Grijalva Estrada, M R Ibarra Rodríguez

{"title":"Assessment of quality indicators in pediatric major outpatient surgery. Influence of the COVID-19 pandemic.","authors":"A Ramírez Calazans, R M Paredes Esteban, O B Grijalva Estrada, M R Ibarra Rodríguez","doi":"10.54847/cp.2023.01.15","DOIUrl":"https://doi.org/10.54847/cp.2023.01.15","url":null,"abstract":"Introduction: Major Outpatient Surgery (MOS) is an organizational and management model for surgical care that allows selected patients to be treated efficiently and safely. Our objective was to evaluate the quality of the different activities through standardized quality indicators, analyzing whether they have been modified during the COVID-19 pandemic.Materials and methods: An observational and comparative descriptive study of the quality indicators (QI) of MOS in our Pediatric Surgery Department from 2019 to 2020 was carried out. In accordance with the International Association for Ambulatory Surgery (IAAS) and the recommendations of the Spanish Ministry of Health and Consumer Affairs, we assessed the basic quality and the degree of family satisfaction of patients undergoing MOS.Results: A total of 848 and 652 interventions were performed in 2019 and 2020, respectively, with a mean age of 6 and 7 years. 539 (ambulatory rate (AR) 63.6%) and 465 (AR 71.3%) MOS surgeries were conducted in 2019 and 2020. In 2019, the overall substitution rate (SR) was 96.8%, hospitalization rate (HR) was 1.67%, suspension rate was 5.94%, and readmission rate was 1.48%. In 2020, the overall IS was 98.3%, HR was 0.86%, suspension rate was 4.73%, and readmission rate was 1.72%. No differences were found in terms of satisfaction between 2020 and 2019.Conclusions: QI allow us to know and analyze the performance and results of the different management units. In our department, the COVID-19 pandemic has not reduced the quality of CMA care.","PeriodicalId":10316,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"36 1","pages":"17-21"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10521022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Extensor digitorum brevis manus bilateral 二进制数字扩展器

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2023-01-01 DOI: 10.54847/cp.2023.02.08

E. Fernández Díez, E. Marti, J. Redondo Sedano, C. Castellano Yáñez, A. Gómez Sánchez, SM Proaño Landazuri, A. Gómez Fraile, MD Delgado Muñoz

引用次数: 0

Asociación entre estenosis subglótica e intubación endotraqueal en pacientes pediátricos traqueostomizados 小儿气管切开术患者声门下狭窄与气管插管的关系

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2023-01-01 DOI: 10.54847/cp.2023.03.02

C. Percul, L. Lerendegui, P. Lobos, D. Liberto, J. Moldes, MM Urquizo

引用次数: 0

Recertification model for scientific-medical societies in Spain. FACME. 西班牙科学医学协会的重新认证模式。FACME。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2022-10-01 DOI: 10.54847/cp.2022.04.14

C Santander

引用次数: 0

Common surgical training program: standardization of learning quality. 常见的外科培训方案:标准化学习质量。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2022-10-01 DOI: 10.54847/cp.2022.04.20

L Álvarez Martínez, E Ruiz Aja, M P Valdivieso Castro, T M Cardenal Alonso-Allende, C M Gálvez Estévez, A Galbarriatu Gutiérrez, M C Matthies Baraibar, F J Álvarez Díaz

{"title":"Common surgical training program: standardization of learning quality.","authors":"L Álvarez Martínez, E Ruiz Aja, M P Valdivieso Castro, T M Cardenal Alonso-Allende, C M Gálvez Estévez, A Galbarriatu Gutiérrez, M C Matthies Baraibar, F J Álvarez Díaz","doi":"10.54847/cp.2022.04.20","DOIUrl":"https://doi.org/10.54847/cp.2022.04.20","url":null,"abstract":"Introduction: The various surgical specialties in our center have used the simulation and experimental surgery resources available for their training tasks in minimally invasive surgery (MIS) in an individualized manner. With this learning model, a great dispersion of effort and expense was observed, so it was decided to create a unified program based on the following: shared learning, synergy among specialties, moderation of the economic cost, and rational use of the facilities.Objective: To describe and assess our consensually designed training program in order to consolidate a shared learning strategy that will enable our residents to acquire and perfect surgical skills in MIS.Materials and methods: The program consists of various increasingly complex phases implemented on a continuous basis throughout the period of specialized training in the virtual laboratory and experimental operating room. The assessment methods were based on quantifiable criteria: percentage of efficiency and completion time of the \"McGill Inanimate System for Training and Evaluation of Laparoscopic Skills\" (MISTELS) exercises at the beginning and end of the program. An economic study was also conducted.Results: 20 residents have completed the program. Mean times show a significant reduction in each of the exercises. The efficiency percentages at the end of the program were higher than at the beginning (p < 0.001). The cost of the program represented a saving of 67.89%.Conclusion: The new MIS training program improved the quality of learning in a safe environment, establishing common criteria among the different specialties and an improved use of resources.","PeriodicalId":10316,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"35 4","pages":"196-203"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33520986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Implementing a pediatric robotic surgery program: future perspectives. 实施儿科机器人手术项目:未来展望。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2022-10-01 DOI: 10.54847/cp.2022.04.19

C Soto Beauregard, J Rodríguez de Alarcón García, E E Domínguez Amillo, M Gómez Cervantes, L F Ávila Ramírez

{"title":"Implementing a pediatric robotic surgery program: future perspectives.","authors":"C Soto Beauregard, J Rodríguez de Alarcón García, E E Domínguez Amillo, M Gómez Cervantes, L F Ávila Ramírez","doi":"10.54847/cp.2022.04.19","DOIUrl":"https://doi.org/10.54847/cp.2022.04.19","url":null,"abstract":"Introduction: The minimally invasive approach using robotic technology is fully incorporated in the treatment of adult pathologies. The first international pediatric studies with a robotic approach date from 2002, and in Spain, from 2009. We present the implementation of a Pediatric Robotic Surgery program in our setting.Materials and methods: A proposal for the application of robotic technology in pediatrics was developed, and after the acquisition of a Da Vinci Xi system at our center, a program was initiated under the guidance of a pediatric surgeon experienced in this approach.Results: 732 patients with a median age of 12 years (7 months-17 years) have been operated on since January 2019. 56% of the procedures were abdominal. 3 thoracic approaches and 11 urologic procedures were carried out. 1 conversion to open surgery was performed during a fundoplication. The median combined duration of abdominal and thoracic approaches was 155 minutes (70-380 minutes). There were no anesthetic or hemodynamic complications. The postoperative period in the cases in which the procedure was completed was uneventful, and patients were discharged after a median of 2 days (1-16 days).Conclusion: The main advantage of robotic procedures is the symmetrical movement in line with the surgeon's hands, which makes the learning curve shorter. In our experience, the robotic approach has allowed for greater precision in the surgical technique, favoring the patient's recovery.","PeriodicalId":10316,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"35 4","pages":"187-195"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33520985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Buried penis secondary to ectopic scrotum. 隐伏的阴茎继发于异位阴囊。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2022-10-01 DOI: 10.54847/cp.2022.04.21

B Fernández Bautista, R Ortiz, L Burgos, I Bada, J M Angulo

引用次数: 0

Pop-off mechanisms as protective factors against chronic renal disease in children with posterior urethral valves. 后尿道瓣膜患儿的弹出机制是预防慢性肾脏疾病的保护因素。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2022-10-01 DOI: 10.54847/cp.2022.04.18

C Massaguer, O Martín-Solé, S Pérez-Bertólez, X Tarrado, L García-Aparicio

{"title":"Pop-off mechanisms as protective factors against chronic renal disease in children with posterior urethral valves.","authors":"C Massaguer, O Martín-Solé, S Pérez-Bertólez, X Tarrado, L García-Aparicio","doi":"10.54847/cp.2022.04.18","DOIUrl":"https://doi.org/10.54847/cp.2022.04.18","url":null,"abstract":"Objective: To identify whether pop-off mechanisms act as protective factors against chronic or end-stage renal disease in patients with posterior urethral valves.Materials and methods: A retrospective cohort study of patients with posterior urethral valves treated at a tertiary care children's hospital was carried out. Demographic, clinical, analytical, and radiological variables were collected. Considered as pop-off mechanisms were: unilateral high-grade vesicoureteral reflux with ipsilateral renal dysplasia and without involvement of the contralateral kidney, urinoma, prenatal urinary ascites, large bladder diverticulum, and persistent urachus. Multiple logistic regression and multivariate Cox regression were used for statistical analysis.Results: 70 patients undergoing posterior urethral valve surgery in our institution from 2010 to August 2020 were included. 14 (20%) had pop-off mechanisms and 56 (80%) did not. Pop-off mechanisms protected against developing chronic renal disease (0% vs. 27%; p = 0.03) and could protect against the need for renal replacement therapy (0% vs. 9%; p = 0.58). Nadir creatinine values (mg/dl) were predictors for the development of chronic renal disease (0.37 vs. 0.53; p < 0.0001) and the need for renal replacement therapy (0.38 vs. 1.21; p < 0.001).Conclusions: Pop-off mechanisms act as a protective factor against chronic renal disease in patients with posterior urethral valves. Nadir creatinine is a predictor of chronic renal disease and the need for renal replacement therapy. A larger sample size is needed to determine whether pop-off mechanisms protect against the need for renal replacement therapy.","PeriodicalId":10316,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"35 4","pages":"180-186"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33520984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Congenital malformations of the urinary tract: progression to chronic renal disease. 先天性尿路畸形:发展为慢性肾脏疾病。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2022-10-01 DOI: 10.54847/cp.2022.04.17

M R Ibarra Rodríguez, M Antón Gamero, A Parente Hernández, S R Wiesner Torres, V Vargas Cruz, R M Paredes Esteban

{"title":"Congenital malformations of the urinary tract: progression to chronic renal disease.","authors":"M R Ibarra Rodríguez, M Antón Gamero, A Parente Hernández, S R Wiesner Torres, V Vargas Cruz, R M Paredes Esteban","doi":"10.54847/cp.2022.04.17","DOIUrl":"https://doi.org/10.54847/cp.2022.04.17","url":null,"abstract":"Introduction: Congenital nephrourological abnormalities (CAKUT) are a particularly relevant group of diseases due to their high prevalence and the fact they are the main cause of chronic renal disease (CRD) in the pediatric population. Our objective was to determine the characteristics and prevalence of CAKUT in our setting, while identifying the factors associated with the occurrence of renal damage.Materials and methods: A retrospective, descriptive, analytical, cross-sectional study of patients seen in the Pediatric Nephrology Department of a third-level hospital from January 1 to December 31, 2018 was carried out. Epidemiological, clinical, and analytical variables were assessed, and potential risk factors associated with CRD were searched for.Results: The study involved 685 patients with 827 kidney units affected by CAKUT with a mean age of 9.98 ± 5.12 years. 62.2% were male, and the mean follow-up period after diagnosis was 9.95 ± 5.09 years. 58.8% were non-obstructive dilations, followed by renal dysplasia, obstructive dilations, and number and position abnormalities. The most frequent malformation was vesicoureteral reflux (VUR). The most commonly affected side was the left (47.5%). 55% of the diagnoses were prenatal. 172 patients underwent surgery. The initially chosen treatment for VUR was endourological. Overall re-intervention rate was 20%. Of the total number of patients, glomerular filtration rate was analyzed in 383, 95 (24.8%) of whom had CRD (86% in stage 2). Male sex, bilaterality, and proteinuria were risk factors associated with CRD.Conclusions: Knowledge of the epidemiological and clinical characteristics of children with CAKUT and the factors associated with CRD helps to individualize the clinical follow-up of these patients, thus customizing diagnostic tests and healthcare resources.","PeriodicalId":10316,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"35 4","pages":"172-179"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33520983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Incidental appendectomy in surgical treatment of ileocolic intussusception in children. Is it safe to perform? 意外阑尾切除术在儿童回结肠肠套叠手术治疗中的应用。表演安全吗?

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2022-10-01 DOI: 10.54847/cp.2022.04.16

C Delgado-Miguel, A García, B Delgado, A Muñoz-Serrano, M Miguel-Ferrero, J I Camps, M López-Santamaría, L Martínez

{"title":"Incidental appendectomy in surgical treatment of ileocolic intussusception in children. Is it safe to perform?","authors":"C Delgado-Miguel, A García, B Delgado, A Muñoz-Serrano, M Miguel-Ferrero, J I Camps, M López-Santamaría, L Martínez","doi":"10.54847/cp.2022.04.16","DOIUrl":"https://doi.org/10.54847/cp.2022.04.16","url":null,"abstract":"Background: Surgical treatment of ileo-colic intussusception (ICI) has been reported as the second cause of emergency laparotomy in children. The performance of incidental appendectomy after surgical reduction is currently controversial. The aim is to analyse the outcomes of performing incidental appendectomy after surgical ICI reduction with or without associated bowel resection.Materials and methods: A retrospective study was performed in patients with ICI episodes, who underwent surgical treatment in our institution between 2005-2019. Patients were divided in two groups according to the performance of associated appendectomy (AA group) or not (NA group). Subsequently, a stratified analysis was performed according to the need for bowel resection in both groups. Demographic variables, intraoperative findings, surgical time, hospital stay, postoperative complications and recurrences were analysed.Results: A total of 101 patients (77 AA group; 24 NA group) were included, without differences in demographics or intraoperative findings. A total of 36 bowel resections were performed (24 group AA; 10 group NA), with no differences in surgical time (55.7 min in group AA vs. 61.2 min in group NA; p = 0.587) or hospital stay (median 5 days in both groups). There were also no differences in postoperative complications or recurrences between the two groups. Stratified analysis showed that bowel resection increases operative time, hospital stay and postoperative complications, regardless of whether associated appendectomy was performed or not.Conclusions: Incidental appendectomy during surgical treatment of ICI in children is a safe procedure that does not increase operative time, hospital stay, postoperative complications or recurrence.","PeriodicalId":10316,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"35 4","pages":"165-171"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33520982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1