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

{"title":"Liposuction reduces surgical time for mastectomy in gynecomastia.","authors":"M Sáenz-Molina, M de la Torre-Macías, C Lorca-García, B Berenguer-Fröhner","doi":"10.54847/cp.2026.02.11","DOIUrl":"https://doi.org/10.54847/cp.2026.02.11","url":null,"abstract":"<p><strong>Introduction: </strong>Mastectomy and liposuction are the most used techniques for the treatment of pubertal gynecomastia. This study compared the surgical time and safety of the combined technique versus isolated mastectomy.</p><p><strong>Material and methods: </strong>A retrospective single-center study was conducted in males with bilateral gynecomastia treated between 2005 and 2022. Patients with synchronous double-field approach, operated by specialists, with prior endocrinological evaluation and a minimum follow-up of 2 years, were included. Two cohorts were established depending on whether or not tumescent liposuction with Klein's solution was associated. Age, BMI, and Simon grade were analyzed, along with intraoperative variables (glandular weight, operative time, and need for drainage), postoperative outcomes, complications, and reinterventions. The analysis was performed with SPSS v20 (statistical significance p<0.05).</p><p><strong>Results: </strong>Of 96 patients, 39 met the criteria: 13 were treated with mastectomy and 26 with the combined technique. The groups were comparable in age, BMI, and gynecomastia grade. The mean glandular weight was 65 vs. 51 g. Combined surgery showed a significantly shorter surgical time (82 vs. 123 min; p<0.005). There were no differences in the placement of drains (2 vs. 1; p= 1). The complication rate was similar: no infections were recorded, and hematomas were 1 vs. 3 (p= 0.06). Global satisfaction was high in both groups (96% vs. 92%). No reoperations were described, with a minimum follow-up of 2 years.</p><p><strong>Conclusions: </strong>The combination of tumescent liposuction and mastectomy significantly reduces operative time, without increasing morbidity or the need for reinterventions.</p>","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"39 2","pages":"53-59"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793858","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}

{"title":"Zoon's balanitis in the pediatric age: Lessons from an unexpected diagnosis.","authors":"M B Oliver, M Aguilera-Pujabet, G Fatou Royo, R Gander, J Camacho, M Asensio","doi":"10.54847/cp.2026.02.17","DOIUrl":"https://doi.org/10.54847/cp.2026.02.17","url":null,"abstract":"<p><strong>Introduction: </strong>Zoon's balanitis circumscripta plasmacellularis (ZB) is a chronic, benign, and idiopathic inflammatory mucositis that affects uncircumcised males, especially those of middle or advanced age. Its appearance in the pediatric population is exceptional and may go unnoticed.</p><p><strong>Clinical case: </strong>We present the case of a 14-year-old male with no relevant medical history and a normal physical examination, except for phimosis without dermatitis or other skin lesions, who underwent elective circumcision. The histopathological study of the foreskin revealed epidermal atrophy, a dense band-like inflammatory infiltrate composed predominantly of plasma cells, extravasation of red blood cells, and marked vascular dilation, with no signs of epithelial dysplasia.</p><p><strong>Comments: </strong>ZB should be included in the differential diagnosis of chronic or refractory balanopreputial lesions in adolescents, characterized by erythematous, shiny plaques with multiple punctate spots affecting the glans, foreskin, or both. Since its clinical expression is often nonspecific, the diagnosis is frequently established incidentally by histopathological analysis. Circumcision is not only the most effective treatment, with a low recurrence rate, but also a diagnostic tool that allows confirmation of the benign nature of the process and avoids prolonged and ineffective topical treatments.</p>","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"39 2","pages":"87-89"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793863","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}

{"title":"A rare case of urinary tuberculosis in a 14-year-old: Diagnosis and surgical management.","authors":"R Mena, R Gander, N Mendoza, A Soriano, M Asensio","doi":"10.54847/cp.2026.02.16","DOIUrl":"https://doi.org/10.54847/cp.2026.02.16","url":null,"abstract":"<p><strong>Introduction: </strong>Urogenital tuberculosis (UG-TB) accounts for 30-40% of extrapulmonary TB (EPTB) cases and is extremely rare in the pediatric age. It is usually diagnosed in advanced stages, and its treatment mostly requires antitubercular therapy combined with surgery.</p><p><strong>Clinical case: </strong>14-year-old patient with no previous history of lung disease, who presented recurrent UTIs (sterile pyuria) and chronic lower urinary tract symptoms. On ultrasound right hydronephrosis was seen, and a CT scan revealed vertebral lesions that led to the diagnosis of TB. Urinary symptoms improved after combined treatment with anticholinergics, suprapubic catheter placement and hyaluronic acid instillations. Additional studies showed right renal atrophy, parenchymatous calcifications and multiple ureteral stenoses. Due to global renal involvement and afunctionality, right nephroureterectomy was performed laparoscopically, without complications. Following completion of antituberculous therapy, the suprapubic catheter was removed and the patient was transitioned to clean intermittent catheterization (CIC). At present, the clinical course is favorable under intermittent catheterization, with no infectious episodes, and regular follow-up of the solitary remaining kidney is maintained.</p><p><strong>Conclusions: </strong>UG-TB must be suspected in patients with recurrent UTIs who present with sterile pyuria. Laparoscopic approach is safe and feasible in spite of the intense scarring associated with this pathology.</p>","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"39 2","pages":"82-86"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793798","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}

{"title":"Impact of early enteral nutrition after transit reconstruction in pediatrics.","authors":"M Sáenz Molina, M Fanjul Gómez, S Monje Fuente, J Bueno Romero, S D Israel Benchaya, D J Peláez Mata, L Pérez Egido, A Del Cañizo López, M A García Casillas, J A Cerdá Berrocal, J C de Agustín Asensio","doi":"10.54847/cp.2026.02.14","DOIUrl":"https://doi.org/10.54847/cp.2026.02.14","url":null,"abstract":"<p><strong>Introduction: </strong>Restoration of intestinal continuity is a common procedure in pediatric surgery. However, controversy persists regarding the optimal timing for initiating postoperative enteral nutrition. Although traditionally a delayed start has been recommended to reduce the risk of complications such as anastomotic leak or paralytic ileus, recent studies in adult populations suggest benefits of early initiation. Evidence in the pediatric population is limited. This study evaluates the safety and clinical outcomes of early versus late enteral nutrition in children undergoing intestinal continuity restoration.</p><p><strong>Material and methods: </strong>Prospective, single-center study with 43 pediatric patients operated between 2018 and 2025. Two groups were compared: early enteral nutrition via oral route (6 hours after surgery) and late nutrition. Demographic variables, type of ostomy, time to recovery of intestinal transit, postoperative complications, duration of epidural analgesia, and length of hospital stay were analyzed.</p><p><strong>Results: </strong>No differences were observed in the overall complication rate between the groups. Patients who received early enteral feeding showed an earlier start of intestinal transit (p= 0.002) and a significant reduction in hospital stay (p= 0.04).</p><p><strong>Conclusions: </strong>The early initiation of oral enteral nutrition after intestinal transit reconstruction in pediatric patients was associated with a shorter time until the restoration of intestinal transit and a reduction in hospital stay, with no observed increase in the incidence of complications. However, multicenter studies with a larger sample size are needed to confirm these findings and establish more robust recommendations.</p>","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"39 2","pages":"72-76"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793925","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}

{"title":"Paratesticular leiomyoma in the pediatric age.","authors":"C Dardanelli, E Cotta, C G Pinto, A Roggero, M Orellano, E Gallino, E Denes","doi":"10.54847/cp.2026.02.18","DOIUrl":"https://doi.org/10.54847/cp.2026.02.18","url":null,"abstract":"<p><strong>Introduction: </strong>Paratesticular leiomyoma is an extremely rare benign neoplasm in the pediatric population, with variable clinical presentations that can mimic other scrotal pathologies.</p><p><strong>Clinical observation: </strong>We present two pediatric patients with paratesticular leiomyoma. The first case was an 11-year-old boy with a long-standing, asymptomatic paratesticular mass, initially suggestive of polyorchidism, approached via a scrotal incision. The second case was a 14-year-old adolescent who presented with testicular pain, with ultrasound findings suggestive of a neoformative process, which required an inguinal exploration. In both cases, complete excision of the lesion was performed, preserving the testicle, and the diagnosis was confirmed by pathology.</p><p><strong>Conclusions: </strong>Paratesticular leiomyoma can pose diagnostic challenges in pediatrics. Complete excision is curative, and the prognosis is excellent.</p>","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"39 2","pages":"90-93"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793888","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}

{"title":"Conservative management of choledocholithiasis in the pediatric age: A safe therapeutic approach.","authors":"C Dardanelli, E Cotta, C G Pinto, G Falcioni, L Toselli, M Maricic, R Pace, H Cusumano, G Bellia Munzón","doi":"10.54847/cp.2026.02.12","DOIUrl":"https://doi.org/10.54847/cp.2026.02.12","url":null,"abstract":"<p><strong>Introduction: </strong>Gallstone disease is an entity on the rise in the pediatric population, and it is estimated that 20-30% of these patients present with associated choledocholithiasis. Currently, there is no definitive consensus regarding the optimal treatment for pediatric choledocholithiasis, with different therapeutic strategies having been proposed. The objective of the present work is to evaluate the safety and feasibility of conservative management and analyze the factors associated with spontaneous resolution.</p><p><strong>Material and methods: </strong>Retrospective observational study of 72 pediatric patients with choledocholithiasis treated between 2021 and 2024. Patients with evidence of choledochal dilation (common bile duct ≥ 7 mm), biochemical alterations (total bilirubin > 1.2 mg/dl, direct bilirubin > 0.3 mg/dl, amylase > 100 U/L, and/or lipase > 36 U/L) were included. Demographic variables, comorbidities, ultrasound findings, biochemical alterations, and time until resolution were analyzed.</p><p><strong>Results: </strong>The mean age was 12.8 years (range 4-17), with a female predominance (69%). Obesity was the main risk factor (80%). 43.4% of the patients (n= 24) presented with persistent choledocholithiasis and required endoscopic retrograde cholangiopancreatography, with pancreatitis recorded in 3 cases and cholangitis in 1 case as post-procedure complications. 66.6% (n= 48) showed spontaneous resolution. Bilirubin normalization was faster than choledochal diameter normalization (2.6 vs. 4 days). All patients with initial pancreatitis spontaneously resolved their choledocholithiasis. Biliary tract dilation was associated with greater choledocholithiasis persistence (p= 0.0395).</p><p><strong>Conclusions: </strong>Conservative management with periodic reevaluations constitutes a safe and effective therapeutic alternative in selected pediatric patients, allowing for the reduction of the need for endoscopic retrograde cholangiopancreatography or biliary tract instrumentation and their associated risks.</p>","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"39 2","pages":"60-64"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793890","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}

{"title":"History and legacy of five surgical instruments.","authors":"J Oliveros-Rivero, O Girón-Vallejo","doi":"10.54847/cp.2026.02.10","DOIUrl":"https://doi.org/10.54847/cp.2026.02.10","url":null,"abstract":"","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"39 2","pages":"49-52"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793905","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}

{"title":"Outcomes of refeeding through mucous fistula based on indications in neonatal surgery.","authors":"A G Barría Rodríguez, M F Torres Cordón, G Guillén Burrieza, S López Fernández, M Martos Rodríguez, C W Ruiz Campillo, J A Molino Gahete","doi":"10.54847/cp.2026.02.13","DOIUrl":"https://doi.org/10.54847/cp.2026.02.13","url":null,"abstract":"<p><strong>Objective: </strong>Mucous fistula refeeding (MFR) preserves intestinal function in ostomized neonates by reinfusing proximal output into the distal limb. We aimed to define its indications, effectiveness and complications.</p><p><strong>Material and methods: </strong>A retrospective review of neonates ostomized after neonatal surgery who received MFR for bowel stimulation/decompression and/or to reduce parenteral nutrition (PN) dependence and complications. Patients were categorized into four groups based on the underlying pathology: intestinal atresia, meconium ileus, intestinal ischemia and necrotizing enterocolitis (NEC).</p><p><strong>Results: </strong>Twenty-nine neonates received MFR. In neonates with intestinal atresia, parenteral nutrition (PN) requirements decreased from 86.6% to 59.5% (p 0.027), accompanied by a significant reduction in the bowel diameter discrepancy ratio, from 12.1:1 to 3.7:1 (p 0.017). In those with NEC, PN requirements decreased from 55% to 50% (p 0.719), although full distal stimulation was achieved. In cases of meconial pathology, PN requirements decreased from 45.5% to 35.5% (p 0.527), with 100% distal transit and lower rates of microcolon (p 0.021). In neonates with intestinal ischemia or focal intestinal perforation, PN requirements decreased from 60.5% to 5% (p < 0.035). The most frequent complications associated with MFR were reflux of intestinal contents (51.1%) and accidental tube displacement (30.3%).</p><p><strong>Conclusions: </strong>Abdominal MFR promotes intestinal growth, reduces parenteral nutrition needs, and aids decompression and stimulation in meconium ileus and intestinal atresia. In NEC, commonly associated with larger resections and less distal remaining colon, no differences have been observed except for stimulating the rest of the colon and checking its permeability prior to reanastomosis.</p>","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"39 2","pages":"65-71"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793935","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}

{"title":"Comparative analysis between mini percutaneous nephrolithotomy and flexible ureterorenoscopy for the management of renal lithiasis.","authors":"A Hernández Pérez, N Gallego Mellado, O Sánchez París, N Albertos Mira-Marcelí, M E Martín Hortiguela, V Díaz Díaz, C Abril Sánchez, J Adatty Molina, A Encinas Goenechea, J Gonzálvez Piñera","doi":"10.54847/cp.2026.02.15","DOIUrl":"https://doi.org/10.54847/cp.2026.02.15","url":null,"abstract":"<p><strong>Objectives: </strong>To describe and compare the effectiveness and complications in our center with mini-percutaneous nephrolithotomy (mini-PCNL) and flexible ureterorenoscopy (URS) techniques for kidney stones.</p><p><strong>Material and methods: </strong>Retrospective study with patients aged 0-14 years undergoing lithotomy at our center from 2009-2024. Demographic variables, medical history, location, size, stone composition, stone-free rate, operative time, hospital stay, and early complications (Clavien-Madadi scale) are analyzed.</p><p><strong>Results: </strong>Twenty cases were obtained: 9 URS and 11 mini-PCNL. The mean age was 8 years (4.71-9.56) with 57.9% males. 42% presented some lithogenic factor (3 cystinuria, 2 hypercalciuria). No differences were found between URS and mini-PCNL groups (p> 0.05) in age, sex, location, size, medical history, composition, operative time [150 (110-250) vs 120 (70-243) min], hospital stay [1 (1-2) vs 1 (1-2) days], or double J stent placement. The stone-free rate was 45% for mini-PCNL and 30% for URS (p= 0.042). The complication rate was 66% for URS [3 cases of urinary tract infection (CM II), 3 stone migration (CM IIIa)]; and 18% for mini-PCNL [1 case of pain (CM II) and 1 stone migration (CM IIIa)], with statistically significant differences being found (p= 0.02, relative risk of complication or RR= 1.14).</p><p><strong>Conclusions: </strong>Mini-PCNL is an effective and safe technique for the treatment of kidney stones, with higher stone-free rates than URS and fewer complications.</p>","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"39 2","pages":"77-81"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793784","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}

{"title":"Myeloid sarcomas: Experience from a pediatric oncology referral center.","authors":"M Banzo Navascués, M Martínez Díaz, J Cortés Sáez, J Mira Abenza, A Marco Macián","doi":"10.54847/cp.2026.01.15","DOIUrl":"https://doi.org/10.54847/cp.2026.01.15","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the experience in the management of myeloid sarcomas at a pediatric oncology referral center.</p><p><strong>Material and methods: </strong>A descriptive, retrospective study of patients under 18 years of age diagnosed with myeloid sarcoma between 2010 and 2024. Demographic variables, underlying disease, tumor location, tumor size, treatment, and clinical outcome were collected. The analysis was performed using IBM® SPSS Statistics 30.0.</p><p><strong>Results: </strong>Seventeen myeloid sarcomas were identified in 14 patients, 13 (76.5%) of whom were male. The median age at diagnosis was 4.33 years (range: 1 month-14.5 years). In 10 cases (58.8%), the sarcoma was the first manifestation of an underlying hematologic malignancy. Biopsy was performed in 12 cases (70.6%). The most frequent locations were soft tissues (47.1%) and bone (23.5%). The mean tumor volume was 45.2 cm3. Acute myeloid leukemia was the most common underlying neoplasm (n= 14), followed by B-cell acute lymphoblastic leukemia (n= 3). Eight myeloid sarcomas (47.1%) resolved after a first cycle of chemotherapy, 6 (35.3%) required additional cycles, 2 (11.8%) received local treatment, and in 1 case (5.9%) resolution was not achieved.</p><p><strong>Conclusions: </strong>Myeloid sarcoma represents an uncommon extramedullary manifestation. Early diagnosis, based on a high index of suspicion and appropriate clinical and radiological characterization, is crucial to establish an effective therapeutic approach and improve prognosis.</p>","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"39 1","pages":"32-36"},"PeriodicalIF":0.0,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146000027","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}