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

Necrotizing enterocolitis and congenital heart disease: differences in management and prognosis. 坏死性小肠结肠炎和先天性心脏病：管理和预后的差异。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2024-10-04 DOI: 10.54847/cp.2024.04.11

R Mena Marcos, G Guillén Burrieza, A Castrillo Arias, S López Fernández, M Martos Rodríguez, A Montaner Ramón, A Creus, M G López Paredes, J A Molino Gahete

{"title":"Necrotizing enterocolitis and congenital heart disease: differences in management and prognosis.","authors":"R Mena Marcos, G Guillén Burrieza, A Castrillo Arias, S López Fernández, M Martos Rodríguez, A Montaner Ramón, A Creus, M G López Paredes, J A Molino Gahete","doi":"10.54847/cp.2024.04.11","DOIUrl":"10.54847/cp.2024.04.11","url":null,"abstract":"Objectives: Necrotizing enterocolitis (NEC) is a main cause of neonatal morbimortality. Gut prematurity and ischemia-reperfusion injury contribute to NEC and characterize two different scenarios: prematurity and congenital cardiopathy (CC). Our aim is to investigate whether CC worsens NEC gastrointestinal and general prognosis.Materials and methods: NEC episodes from 2015-2023 were reviewed and classified into CC and non-CC. Patients with focal intestinal perforation were excluded. Data regarding NEC debut and management, surgical timing, intestinal segment involved and short-term outcomes were compared.Results: Out of 205 neonates, 15 were excluded for unavailable records or uncertain diagnosis. 190 cases were included, 59 with CC. Comparing CC and non-CC, no significant differences were found in weight or age at diagnosis, or NEC stage. Hemodynamic (HD) shock [38.98% vs 24.43% (p < 0.05)] and need for vasoactive support at debut were more frequent in CC patients [44.07% vs 23.66% (p < 0.05)]. No differences were found regarding need for surgery at debut, length of resected intestine or segment affected or days on parenteral nutrition. CC conditioned longer hospital stay [110.8 ± 68.4 days vs 68.4 ± 44.6 (p < 0.05)] and higher mortality [30.5 vs 11.5 (p < 0.05)].Conclusions: NEC in CC patients presents more HD instability at debut and worse global prognosis, probably due to inherent cardiovascular compromise, but need for surgery, type of intestinal involvement and short-term outcomes are similar to non-CC NEC.","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592424","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

Posterior urethral valves: risk factors of progression to end-stage chronic renal disease after 10 years of follow-up. 后尿道瓣膜：10 年随访后发展为终末期慢性肾病的风险因素。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2024-10-04 DOI: 10.54847/cp.2024.04.14

L Díaz Menéndez, I Casal Beloy, S Roldán Pérez, R M Romero Ruiz

{"title":"Posterior urethral valves: risk factors of progression to end-stage chronic renal disease after 10 years of follow-up.","authors":"L Díaz Menéndez, I Casal Beloy, S Roldán Pérez, R M Romero Ruiz","doi":"10.54847/cp.2024.04.14","DOIUrl":"10.54847/cp.2024.04.14","url":null,"abstract":"Objective: To determine risk factors (RF) of progression to end-stage chronic renal disease (ESCRD) and the need for renal replacement therapy (RRT) in patients with posterior urethral valve (PUV).Materials and methods: A retrospective case and control study of patients diagnosed with PUV in the 1995-2023 period was carried out. Two study groups were created -RRT vs. no-RRT. Clinical, laboratory, and radiological variables were collected. A bivariate analysis and a binary logistic regression were conducted to detect RFs of the need for RRT.Results: 127 patients were included, 12.% of whom had undergone RRT (n= 20). Mean follow-up was 9.87 years. Mean age at clinical onset was younger in the RRT group (3 months vs. 1.23 years; p= 0.010). Pathological prenatal ultrasonography (p< 0.001), increased Nadir creatinine levels (p< 0.001) and maximum creatinine levels in the first year of life (p< 0.001), and onset with acute renal insufficiency (p= 0.03) were more frequent in the RRT group. Increased creatinine levels in the first week of life (OR: 4.74) and younger age at clinical onset (OR: 1.2) were the only independent RFs to predict the need for RRT. Diagnostic-therapeutic delay and the presence of UTIs during follow-up are not predictive of the risk of final RRT.Conclusions: In PUV children, renal functional reserve at birth is the only ESCRD risk predictor. Early clinical onset implies a higher risk of RRT.","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592433","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

Evaluation of quality of life and satisfaction in patients undergoing laparoscopic Mitrofanoff procedure. 对腹腔镜米特罗凡诺夫手术患者的生活质量和满意度进行评估。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2024-10-04 DOI: 10.54847/cp.2024.04.15

M B Oliver, R Gander, G Fatou Royo, M Aguilera, M López, M Asensio

{"title":"Evaluation of quality of life and satisfaction in patients undergoing laparoscopic Mitrofanoff procedure.","authors":"M B Oliver, R Gander, G Fatou Royo, M Aguilera, M López, M Asensio","doi":"10.54847/cp.2024.04.15","DOIUrl":"10.54847/cp.2024.04.15","url":null,"abstract":"Objectives: The Mitrofanoff principle has been extensively evaluated in terms of associated morbidity and mortality. However, there is limited literature specifically addressing quality of life (QoL), particularly concerning the laparoscopic procedure. The aim of this study was to assess the impact of laparoscopic appendicovesicostomy (LA) on QoL by using a specific questionnaire targeted at patients and their families.Materials and methods: This observational and descriptive study involved patients who underwent LA between May 2018 and December 2023. A survey consisting of 29 questions, organized into three sections was used: satisfaction with the surgery, outcomes, and current continence status. Responses were graded according to the Likert scale (1-5) (1 = strongly disagree, 5 = strongly agree).Results: Of the 29 contacted families, 24 (82.8%) responded. The average age was 12.3 years (SD 4.4), with 75.9% being male. The primary indication for surgery was pain during urethral catheterization (69%). Mean postoperative follow-up was 36.5 months. Regarding satisfaction with surgery: overall satisfaction,hospitalization duration and pain control was rated with a score of 5 by 66.7%, 58.3% and 58.3%, respectively. In terms of outcomes: 54.2% rated aesthetic results with a score of 5, and 83.3% rated improvement in QoL with a score of 4 or 5. Concerning current continence status, 66.6% were very satisfied with the results and reported total absence of leakages or on a very specific occasion (score of 4 or 5).Conclusions: This study supports the improvement in perceived QoL among patients requiring an LA. Overall satisfaction with the procedure and outcomes related to continence were perceived as very good by both patients and their families.","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592418","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

Prenatally diagnosed segmental intestinal dilatation associated with anorectal malformation. 产前诊断为伴有肛门直肠畸形的节段性肠管扩张。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2024-10-04 DOI: 10.54847/cp.2024.04.16

J P Camacho, J E Udaquiola, D H Liberto, P X de la Iglesia, P A Lobos

引用次数: 0

Posterior rectal advancement with fistula preservation in patients with anorectal malformation. A multicenter study. 保留肛门直肠畸形患者瘘管的直肠后方推进术。一项多中心研究。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2024-10-04 DOI: 10.54847/cp.2024.04.13

C Ramirez Amorós, C Gine Prades, M San Basilio, M Fanjul, A Sánchez Galán, M J Martínez Urrutia, A Vilanova-Sanchez

{"title":"Posterior rectal advancement with fistula preservation in patients with anorectal malformation. A multicenter study.","authors":"C Ramirez Amorós, C Gine Prades, M San Basilio, M Fanjul, A Sánchez Galán, M J Martínez Urrutia, A Vilanova-Sanchez","doi":"10.54847/cp.2024.04.13","DOIUrl":"10.54847/cp.2024.04.13","url":null,"abstract":"Background: Anorectal malformations (ARM) with rectoperineal fistula are mainly repaired with a posterior sagittal anorectoplasty (PSARP), which can be challenging given the proximity of the fistula to the vagina and urethra. The posterior rectal advancement anoplasty (PRAA), preserves the anterior wall of the fistula without leaving an anterior or a posterior sagittal incision. It is indicated for selected cases of ARM with rectoperineal fistula in which the anterior aspect of the fistula is partially surrounded by sphincter complex.Methods: Multicentre and retrospective study of patients with rectoperineal fistula treated with PRAA. We analysed gender, associated malformations, age, operative time, short and long-term results, and complications.Results: 18 patients aged 93.5 (1.75-312) days underwent PRAA. Surgical time was 35 (25-45) minutes and feeding was started at 24 (5-48) hours postoperatively. There were no vaginal or urethral injuries, no wound infections or dehiscenses. Throughout the 38 (12.75-45.50) months of follow-up there were no anal strictures. All patients are passing stool, 11 (61%) of them with the need of a low dose stool softener.Conclusion: Selected patients with rectoperineal fistula can be treated with PRAA with a shorter surgical time and hospital stay. This technique provides good results and lower risk of injury to neighbouring structures.","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592430","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

Optimizing pediatric laparoscopic cholecystectomy: trocar reduction with percutaneous gallblader traction. 优化小儿腹腔镜胆囊切除术：通过经皮胆囊牵引减少套管。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2024-10-04 DOI: 10.54847/cp.2024.04.12

G M Gavilanes Salazar, O B Grijalva Estrada, A Sáenz Dorado, I Ibarra Rodríguez, R Ramírez Díaz, J Bueno Recio

{"title":"Optimizing pediatric laparoscopic cholecystectomy: trocar reduction with percutaneous gallblader traction.","authors":"G M Gavilanes Salazar, O B Grijalva Estrada, A Sáenz Dorado, I Ibarra Rodríguez, R Ramírez Díaz, J Bueno Recio","doi":"10.54847/cp.2024.04.12","DOIUrl":"10.54847/cp.2024.04.12","url":null,"abstract":"Objective: Laparoscopic cholecystectomy is typically carried out using four ports. The objective of this study was to describe the percutaneous gallbladder traction technique, which allows the number of ports to be reduced, thus optimizing the procedure, with a similar exposure of the surgical site.Materials and methods: 2 pediatric patients with symptomatic cholelithiasis underwent laparoscopic surgery from January 2021 to January 2024. Cholecystectomy was performed using an umbilical port (5 mm, 30-degree scope) and two accessory ports. A laparoscopic loop with a running knot was used to conduct percutaneous gallbladder traction at the right intercostal level.Results: All surgeries were successfully completed. Mean operating time was 90 minutes. Hospital stay was 1-2 days. Postoperative progression was favorable in all patients.Conclusions: These results confirm that cholecystectomy with percutaneous gallbladder traction is safe, cost-effective, and easily reproducible, which means it can be an alternative to the classic technique.","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592428","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

How far do we want to go? 我们想走多远？

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2024-10-04 DOI: 10.54847/cp.2024.04.09

V Ibáñez Pradas

引用次数: 0

Innovation and challenges: minimally invasive surgery training in Latin America. 创新与挑战：拉丁美洲的微创外科培训。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2024-10-04 DOI: 10.54847/cp.2024.04.10

L Rollan, C Gigena, I Diaz Saubidet, S Valverde, G Bellia-Munzon, C Millán

{"title":"Innovation and challenges: minimally invasive surgery training in Latin America.","authors":"L Rollan, C Gigena, I Diaz Saubidet, S Valverde, G Bellia-Munzon, C Millán","doi":"10.54847/cp.2024.04.10","DOIUrl":"10.54847/cp.2024.04.10","url":null,"abstract":"Objective: Our objective was to assess the current status of minimally invasive surgery (MIS) training in Latin America and to identify the primary hurdles for the acquisition of laparoscopic skills.Materials and methods: An anonymous survey was launched on various social media in November 2022. Surgeon responses were analyzed.Results: 131 pediatric surgeons from 98 surgical institutions in 16 Latin-American countries replied to the survey. MIS training during residency was found in 45.9% of the surgeons with > 20 years' experience, and in 95.2% of the surgeons with < 10 years' experience. A median of 3 courses (IQR: 2; 5) had been completed by 116 surgeons (88.5%), 70.2% of them ≤ 3 days long, and 85.4% self-funded. The primary hurdles to attend them were the lack of financial resources and/or the absence of local courses (80%). Virtual courses were regarded as a recommendable option to acquire laparoscopic skills by 100 (76.3%) respondents.Conclusions: MIS training in Latin America has exponentially increased in the last decades. However, training programs have room for improvement, which means training is highly surgeon-dependent, since courses are selected and self-funded by surgeons themselves.","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592422","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

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