Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica最新文献

Limitations and complications of robotic urological surgery in younger children: debunking old beliefs. 低龄儿童机器人泌尿外科手术的局限性和并发症：破除旧观念。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2024-07-09 DOI: 10.54847/cp.2024.03.14

J González-Cayón, A Parente, J I Garrido, V Vargas, R M Paredes

{"title":"Limitations and complications of robotic urological surgery in younger children: debunking old beliefs.","authors":"J González-Cayón, A Parente, J I Garrido, V Vargas, R M Paredes","doi":"10.54847/cp.2024.03.14","DOIUrl":"https://doi.org/10.54847/cp.2024.03.14","url":null,"abstract":"Introduction: Even though certain technical limitations associated with the small size of the patients were taken for granted in the advent of pediatric robotic surgery, we could now be facing a paradigm shift challenging these old beliefs.Materials and methods: A retrospective study of patients undergoing Da-Vinci-Xi(IS4000)-assisted urological surgery from May 2022 to October 2023 was carried out. Patients were divided into two groups -Group A < 15 kg and Group B ≥ 15 kg. Operating times, hospital stay, and intra- and postoperative complications were compared.Results: 17 patients (9 in Group A, 8 in Group B) underwent surgery. Median age was 29 months (A) and 109 months (B) (p< 0.001). Median weight was 12.0 kg (A) and 31.5 kg (p< 0.001). Operating time was 162 min (A) and 130 min (p= 0.203). Console time was 99 min (A) and 70 min (B) (p= 0.065). Mean hospital stay was 2 days (A) and 3 days (B) (p= 0.41). No differences were found in terms of intraoperative (p= 0.453) or postoperative (p= 0.485) complications.Conclusions: Even though operating on younger children seemed more complicated than on older ones in the advent of robotic surgery, the results in our series were similar. The fact patients under 12 months of age were not included means larger studies are required to prove this.","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141736308","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

Late effects of Wilms' tumor treatment. 威尔姆斯肿瘤治疗的后期影响。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2024-07-09 DOI: 10.54847/cp.2024.03.13

S Silvente Bernal, O Girón Vallejo, A Sánchez Sánchez, C Menacho Hernández, J Rodón Berrío, B A Parra Gelder

{"title":"Late effects of Wilms' tumor treatment.","authors":"S Silvente Bernal, O Girón Vallejo, A Sánchez Sánchez, C Menacho Hernández, J Rodón Berrío, B A Parra Gelder","doi":"10.54847/cp.2024.03.13","DOIUrl":"https://doi.org/10.54847/cp.2024.03.13","url":null,"abstract":"Introduction: Wilms' tumor (WT) is the most frequent renal tumor in childhood. Therapeutic management progression has increased survival rates, and as a result, long-term adverse effects.Materials and methods: A descriptive retrospective study of a case series from 1977 to 2023 was carried out. The characteristics of the treatments received and the adverse effects listed on medical records were analyzed via phone surveys.Results: 50 patients (25 boys-25 girls) with a mean age of 3.6 years (3 months-11 years) at diagnosis were included. Most of them (94%) were treated according to the protocol established by the European standards of pediatric oncology, which are characterized by the use of neoadjuvant chemotherapy. In one patient, the American treatment scheme was followed. The most common drugs used were vincristine and actinomycin D (78%). Only 12 patients (28%) received anthracyclines. Unilateral nephrectomy was the most frequent surgical technique (84%). Renal disorders were the most common (46%). However, the occurrence of second neoplasias (9%) and reproductive disorders (8% between boys and girls) had a greater impact on patients' quality of life. Multiple - cardiac (23%), endocrine (26%), and pulmonary (15%) - disorders associated with the treatments received were reported.Conclusions: WT treatment has an impact on health. Adequate and rigorous surgery, close follow-up, and limiting chemotherapy doses and radiation exposure can minimize long-term sequels.","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141736307","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

Usefulness of indocyanine green in the laparoscopic Palomo technique: a comparative study. 吲哚菁绿在腹腔镜帕洛莫技术中的应用：一项比较研究。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2024-07-09 DOI: 10.54847/cp.2024.03.15

S Monje Fuente, B Fernández Bautista, M D Blanco Verdú, I Bada Bosch, R Ortiz Rodríguez, L Burgos Lucena, J C De Agustín, J M Angulo Madero

{"title":"Usefulness of indocyanine green in the laparoscopic Palomo technique: a comparative study.","authors":"S Monje Fuente, B Fernández Bautista, M D Blanco Verdú, I Bada Bosch, R Ortiz Rodríguez, L Burgos Lucena, J C De Agustín, J M Angulo Madero","doi":"10.54847/cp.2024.03.15","DOIUrl":"https://doi.org/10.54847/cp.2024.03.15","url":null,"abstract":"Objective: To find out whether the use of indocyanine green for lymphatic sparing in the laparoscopic Palomo technique reduces the incidence of postoperative hydrocele.Materials and methods: A comparative cohort study of varicocele patients treated with the laparoscopic Palomo technique from 2008 to 2023 was carried out. Patients were divided into two groups according to whether fluorescence lymphography (intratesticular indocyanine green) had been performed or not. Epidemiological, surgical, and clinical data, as well as complications, were recorded. A hypothesis test was conducted using the SPSS software.Results: 30 patients undergoing varicocele surgery through the laparoscopic Palomo technique were included. They were divided into two groups -lymphatic sparing (n= 13) vs. spermatic vessel ligation without sparing (n= 17). Mean age at surgery was 14 years. 5 cases of postoperative hydrocele were identified in the no lymphatic sparing group. 1 of them required surgery for hydrocele treatment. No hydrocele cases were noted in the lymphography group. The difference was statistically significant (p= 0.032). There were no statistically significant differences in terms of operating times or mean hospital stay. No recurrences, postoperative testicular atrophies, or indocyanine-green-related complications were recorded. Mean follow-up was 11.4 months.Conclusions: The use of indocyanine green for lymphatic sparing in the treatment of varicocele through the laparoscopic Palomo technique significantly reduces the incidence of postoperative hydrocele.","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141736310","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

Application of botulinum toxin in the repair of a complex ventral hernia. 应用肉毒杆菌毒素修复复杂腹股沟疝。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2024-07-09 DOI: 10.54847/cp.2024.03.16

S D Israel Benchaya, D J Peláez Mata, M A García-Casillas, I Bada Bosch, S Monje Fuente, A M Lancharro Zapata, J C De Agustín

引用次数: 0

Complete ureteropelvic-junction disruption following renal trauma: conservative management. 肾外伤后输尿管肾盂连接处完全断裂：保守治疗。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2024-07-09 DOI: 10.54847/cp.2024.03.18

M B Oliver Vall-Llosera, R Gander, G Royo Gomes, M Aguilera Pujabet, O Rocha Guzmán, M López Paredes, M Asensio Lorente

{"title":"Complete ureteropelvic-junction disruption following renal trauma: conservative management.","authors":"M B Oliver Vall-Llosera, R Gander, G Royo Gomes, M Aguilera Pujabet, O Rocha Guzmán, M López Paredes, M Asensio Lorente","doi":"10.54847/cp.2024.03.18","DOIUrl":"https://doi.org/10.54847/cp.2024.03.18","url":null,"abstract":"Introduction: Surgical exploration in complete ureteropelvic-junction disruption (CUPJD) is still recommended by many authors. Conservative approach to pediatric renal trauma (RT) includes minimally invasive techniques such as nephrostomy, angioembolization or double-J stent placement.Case report: A 14-year-old patient with CUPJD was treated conservatively. CT-scan revealed active bleeding of the renal artery and significant urine extravasation. Coil angioembolization and nephrostomy placement were performed. An attempt to place a double-J stent was unsuccessful and surgical reconstruction was scheduled. Before surgery, methylene-blue was injected through the nephrostomy observing blue urine output through urethra. Antegrade pyelogram revealed drainage from the urinoma to the ureter. A new attempt to place an internal-external double-J-stent was successful. After 5 weeks, it was removed with total restoration of the urinary tract.Conclusion: Complete urinary tract restoration in some cases of CUPJD following RT is possible through a nonoperative approach. It can be safe and effective, reducing the risk of complications associated with complex surgeries.","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141736303","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

Trend in predictive factors of choledocholithiasis: the key to the management of pediatric patients with suspected gallstones. 胆石症预测因素的趋势：处理疑似胆结石儿科患者的关键。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2024-07-09 DOI: 10.54847/cp.2024.03.12

M A Capparelli, S Canestrari, R Ortiz, P D D'Alessandro, V H Ayarzabal, M E Barrenechea

{"title":"Trend in predictive factors of choledocholithiasis: the key to the management of pediatric patients with suspected gallstones.","authors":"M A Capparelli, S Canestrari, R Ortiz, P D D'Alessandro, V H Ayarzabal, M E Barrenechea","doi":"10.54847/cp.2024.03.12","DOIUrl":"https://doi.org/10.54847/cp.2024.03.12","url":null,"abstract":"Objectives: To reduce the overuse of magnetic resonance cholangiopancreatography and the rates of non-therapeutic endoscopic retrograde cholangiopancreatography in pediatric patients suspected of choledocholithiasis.Materials and methods: Retrospective study of patients suspected of choledocholithiasis between January 2010 and June 2023. Patients with cholangitis or two or more of the following predictive factors of choledocholithiasis in initial laboratory tests and ultrasound were categorized as high-risk group: total bilirubin level ≥ 2 mg/dl, common bile duct > 6 millimeters on ultrasound; and detection of choledocholithiasis by ultrasound. Patients were recategorized according to the results of the second set of laboratory and ultrasound analysis. Confirmatory modalities (magnetic resonance cholangiopancreatography, endoscopic retrograde cholangiopancreatography, and/or intraoperative cholangiography) were used to evaluate the presence of choledocholithiasis. Finally, we assessed the predictive capability of both the initial high-risk group and the group after recategorization.Results: A total of 129 patients were included. After initial studies, 72 (55.8%) patients were classified into the high-risk group. After recategorization, only 29 (22.5%) patients were included in this group. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of the initial high-risk group were 89.3%, 53.5%, 34.7%, 94.7%, and 61.2%, respectively, while after recategorization, they were 82.1%, 94.1%, 79.3%, 95.0%, and 91.5%, respectively.Conclusions: Recategorization of the risk of choledocholithiasis would significantly improve the diagnostic accuracy of choledocholithiasis and help reduce the overuse of more complex and unnecessary studies/procedures.","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141736309","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

Fortified milk: a rare cause of intestinal obstruction in pre-term patients. 强化牛奶：导致早产儿肠梗阻的罕见原因。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2024-07-09 DOI: 10.54847/cp.2024.03.17

R Ramírez Díaz, I Ibarra Rodríguez, G M Gavilanes Salazar, C Moreno Hurtado, M R Chamorro Juárez

{"title":"Fortified milk: a rare cause of intestinal obstruction in pre-term patients.","authors":"R Ramírez Díaz, I Ibarra Rodríguez, G M Gavilanes Salazar, C Moreno Hurtado, M R Chamorro Juárez","doi":"10.54847/cp.2024.03.17","DOIUrl":"https://doi.org/10.54847/cp.2024.03.17","url":null,"abstract":"Introduction: Intestinal obstruction secondary to the use of fortified milk is a rare cause in pre-term patients.Case report: We present the case of a female pre-term newborn admitted as a result of abdominal distension and rectal bleeding, which mimicked necrotizing enterocolitis. On abdominal X-ray, she had an obstruction pattern, and on ultrasonography, echogenic masses at the distal ileum were observed. Given the lack of improvement with conservative management, urgent exploratory laparotomy was decided upon. At surgery, compact milk masses at the level of the distal ileum were identified as the cause of intestinal obstruction. Appendicostomy and lavage with saline solution through the ileocecal valve were performed. This allowed milk masses to come out towards the colon, and a great amount of acholic stools to be expelled.Conclusion: The increase in \"milk curd syndrome\" cases should lead us to consider this cause in the differential diagnosis of intestinal obstruction in pre-term newborns fed with fortified milk.","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141736304","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

Intralesional steroids in refractory caustic esophageal stricture. 治疗难治性腐蚀性食管狭窄的区域内类固醇。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2024-07-09 DOI: 10.54847/cp.2024.03.11

M Martínez Díaz, V Ibáñez Pradas, M Couselo Jerez, E Valdés Diéguez, I Viguria Marco

{"title":"Intralesional steroids in refractory caustic esophageal stricture.","authors":"M Martínez Díaz, V Ibáñez Pradas, M Couselo Jerez, E Valdés Diéguez, I Viguria Marco","doi":"10.54847/cp.2024.03.11","DOIUrl":"https://doi.org/10.54847/cp.2024.03.11","url":null,"abstract":"Objective: To analyze the efficacy of intralesional steroid treatment in refractory caustic esophageal stricture.Materials and methods: An analytical, retrospective study of patients receiving intralesional steroid treatment with triamcinolone acetonide as a result of refractory caustic esophageal stricture was carried out. Demographic variables, stricture characteristics, number of dilations, steroid injections, and dilation score (no. of dilations/follow-up period in months) pre- and post-treatment were collected. Stricture characteristics (diameter and length) and dilation score pre- and post-treatment were compared using the T-Test or Wilcoxon test.Results: N= 5. Median age: 5 years (17 months-7 years). Follow-up: 6.60 ± 2.70 years. Swallowed products included NaOH, KOH, and ClH. Zargar classification at follow-up initiation was IIb (n= 2), IIIa (n= 1), and two chronic strictures. 6.6 ± 9.23 esophageal dilations were carried out before steroid treatment initiation. The mean number of intralesional therapy sessions was 11.20 ± 6.14. Stricture length decreased by 3.60 ± 2.63 cm (t= 3.06; p= 0.019). No differences were found in terms of diameter increase: -1.60 ± 3.58 mm (t= -1.00; p= 0.187). The dilation score diminished from 1.47 ± 0.86 to 0.47 ± 0.18 dilations per month of follow-up (Z= -2.02; p= 0.043).Conclusions: Even though there is limited evidence available in the pediatric population, intralesional triamcinolone treatment is seemingly useful in the treatment of refractory caustic esophageal stricture, since it reduces length and dilation score.","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141736306","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

Indwelling-tunneled-central-venous-catheter-related early bacteremia and preoperative prophylaxis: a case and control study. 与留置导管相关的早期菌血症和术前预防：一项病例和对照研究。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2024-07-09 DOI: 10.54847/cp.2024.03.10

I Planas Díaz, M Molina Mata, I Casal Beloy, R Cabello Laureano

{"title":"Indwelling-tunneled-central-venous-catheter-related early bacteremia and preoperative prophylaxis: a case and control study.","authors":"I Planas Díaz, M Molina Mata, I Casal Beloy, R Cabello Laureano","doi":"10.54847/cp.2024.03.10","DOIUrl":"https://doi.org/10.54847/cp.2024.03.10","url":null,"abstract":"Introduction: The indication of preoperative prophylaxis in the insertion of indwelling tunneled central venous catheters (ITCVC) has a low level of evidence. Our objective was to assess risk factors of ITCVC-related early bacteremia in oncological pediatric patients and to determine the need for preoperative prophylaxis.Materials and methods: A univariate and multivariate retrospective analysis of patients in whom an ITCVC was placed from January 2020 to July 2023, according to whether they had ITCVC-related early bacteremia (EB) in the first 30 postoperative days, was carried out. Demographic variables, leukopenia, neutropenia, use of preoperative antibiotic prophylaxis, and history of central venous catheter (CVC) or bacteremia were collected. Calculations were carried out using the IBM SSPS29® software.Results: 176 patients with a mean age of 7.6 years (SD: 4.82) were analyzed. 7 EB cases were identified, with a greater frequency of neutropenia (p= 0.2), history of CVC in the 48 hours before insertion (p= 0.08), and intraoperative CVC (p= 0.04). The presence of intraoperative CVC increased the risk of EB 9-fold [OR: 9.4 (95%CI: 1.288-69.712) (p= 0.027)]. The lack of preoperative prophylaxis did not increase the risk of EB [OR: 2.2 (CI: 0.383-12.669) (p= 0.3)]. The association with other variables was not significant.Conclusions: The intraoperative presence of CVC was a risk factor of EB in our patients. Preoperative prophylaxis had no impact on the risk of EB, which in our view does not support its use. However, further studies with a larger sample size are required. Leukopenia or neutropenia at diagnosis were not associated with a greater prevalence of infection.","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141736305","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

Benefits of standardization in the management of acute appendicitis. 急性阑尾炎标准化管理的益处。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2024-01-01 DOI: 10.54847/cp.2024.01.10

I Planas Díaz, L Díaz Menéndez, R Cabello Laureano, M Molina

{"title":"Benefits of standardization in the management of acute appendicitis.","authors":"I Planas Díaz, L Díaz Menéndez, R Cabello Laureano, M Molina","doi":"10.54847/cp.2024.01.10","DOIUrl":"10.54847/cp.2024.01.10","url":null,"abstract":"Objective: Acute appendicitis (AA) is the most frequent urgent surgical pathology in the pediatric population, but postoperative management is variable, with protocols minimizing variability. We present our results following the optimization of the management protocol in our institution in order to establish its efficacy in terms of number of infectious complications and optimization of resources in our environment.Materials and methods: An observational, retrospective study of patients undergoing AA surgery from January 2018 to August 2022 was carried out. Two cohorts were compared, both before (1) and after (2) the implementation of the new protocol. They were divided according to severity in order to conduct a subgroup-based analysis -phlegmonous (PH), gangrenous (G), and perforated (P) appendicitis.Results: 771 patients (1: 390; 2: 381) were included, with a homogeneous distribution and a median age of 9.3 ± 2.8 years. Blood tests requested prior to discharge experienced a significant reduction (PH: 3.9% vs. 0.5%; p= 0.026; G: 97.6% vs. 13.4%, p< 0.001). Days of hospital stay decreased in the PH (1.2 IQR: 0.7 vs. 1 IQR: 0.36; p< 0.001) and G (4 IQR: 1 vs. 3 IQR: 1 days; p< 0.001) subgroups. No differences in the number of abscesses were found between groups (41 vs. 43; p= 0.73), but they were noted within subgroup G (9 vs. 2; p= 0.029). A reduction in resource expenses was detected in PH and G appendicitis.Conclusions: In our study, the most widely benefited subgroup following protocol optimization was the gangrenous appendicitis subgroup, with a significant reduction in the number of complications and the use of hospital resources.","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139099458","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