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

{"title":"Challenging anatomy: situs inversus, duodenal web, and intestinal malrotation in a neonate.","authors":"B M Malatini Kozac, A G Morales, P G Mejia Cordova, M B González, H Ges","doi":"10.54847/cp.2026.03.19","DOIUrl":"https://doi.org/10.54847/cp.2026.03.19","url":null,"abstract":"<p><strong>Introduction: </strong>Situs inversus totalis is a rare congenital anomaly, with an estimated incidence of 1 in 10,000 live births worldwide. Its association with intestinal malrotation and a duodenal web is exceptional, with only a few clinical cases reported in the literature.</p><p><strong>Clinical case: </strong>A full-term neonate presented with signs of intestinal obstruction. Chest and abdominal radiography and ultrasonography led to the diagnosis of situs inversus totalis and duodenal obstruction on the first day of life. An intraoperative contrast study confirmed intestinal malrotation. A Ladd procedure and resection of the duodenal web were performed through a supraumbilical midline approach. The patient had a favorable postoperative course.</p><p><strong>Comments: </strong>In neonates with situs inversus and intestinal obstruction, we suggest considering intestinal malrotation and a duodenal web as possible concomitant diagnoses. Imaging studies are essential for establishing the surgical strategy.</p>","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"39 3","pages":"128-130"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564172","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":"Duplicated thyroglossal duct cyst with intrathyroidal involvement in a paediatric patient.","authors":"M De la Torre, M Mescheriakov, R Tejerina, A Lancharro, P Troncoso, I Díez, F Manzarbeitia, R Díez","doi":"10.54847/cp.2026.03.21","DOIUrl":"https://doi.org/10.54847/cp.2026.03.21","url":null,"abstract":"<p><strong>Introduction: </strong>Thyroglossal duct cysts are the most common congenital cervical lesions in childhood. Intrathyroidal location and duplication or bifurcation of the duct are exceptionally rare variants.</p><p><strong>Case report: </strong>An 11-year-old boy presented with two cervical masses: one subcutaneous lesion in the left infrahyoid region and another deep lesion in the right thyroid lobe. Ultrasonography and magnetic resonance imaging identified a 2 × 2 cm intrathyroidal cyst and a 3 × 3 cm subcutaneous lesion, findings consistent with a duplicated thyroglossal duct cyst with intrathyroidal involvement. A Sistrunk procedure was performed, with en bloc excision of both lesions. Histopathological examination confirmed ductal duplication, with one branch extending into the thyroid gland.</p><p><strong>Comments: </strong>This case highlights the importance of advanced imaging in atypical or recurrent cervical lesions and emphasises the need to consider uncommon embryological variants of the thyroglossal duct.</p>","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"39 3","pages":"136-139"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564282","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":"Single-port transumbilical laparoscopic appendectomy combined with Ladd procedure in intestinal malrotation: A case report.","authors":"S Pérez-Bertólez, J Godoy-Lenz, C Abello","doi":"10.54847/cp.2026.03.20","DOIUrl":"https://doi.org/10.54847/cp.2026.03.20","url":null,"abstract":"<p><strong>Introduction: </strong>Acute appendicitis associated with intestinal malrotation is uncommon and may pose diagnostic and technical challenges. We report the first described case of appendectomy associated with Ladd procedure performed through a single-port transumbilical laparoscopic approach.</p><p><strong>Clinical case: </strong>A 9-year-old girl presented with acute abdominal symptoms on a background of chronic recurrent abdominal pain. Imaging revealed acute appendicitis in an atypical supravesical position and inversion of mesenteric vessels consistent with intestinal malrotation without volvulus. A single-port transumbilical laparoscopic approach was used, allowing simultaneous appendectomy and Ladd procedure through the same umbilical access. The postoperative course was uneventful, and the patient was discharged on postoperative day one. At one year of follow-up, she remains asymptomatic with an excellent cosmetic result.</p><p><strong>Conclusion: </strong>Single-port transumbilical laparoscopy enabled safe and effective combined management of appendicitis and intestinal malrotation and may represent a minimally invasive alternative in selected pediatric patients.</p>","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"39 3","pages":"131-135"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564285","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 controversial fetal surgery in the general press.","authors":"J L Encinas Hernández","doi":"10.54847/cp.2026.03.22","DOIUrl":"https://doi.org/10.54847/cp.2026.03.22","url":null,"abstract":"","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"39 3","pages":"140-141"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148563617","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":"Formative perception of 4th and 5th year Pediatric Surgery residents in Spain.","authors":"E Comajuncosas Pérez, J C Moreno-Alfonso, A Y Molina Caballero, A Pérez Martínez","doi":"10.54847/cp.2026.03.14","DOIUrl":"https://doi.org/10.54847/cp.2026.03.14","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the perception of autonomy and the main formative strengths and weaknesses of fourth-year (R4) and fifth-year (R5) Pediatric Surgery residents (MIR) in Spain, in order to identify areas for improvement in their surgical and clinical training.</p><p><strong>Material and methods: </strong>A descriptive cross-sectional study was conducted using an anonymous survey distributed via Google Forms during the last quarter of 2023. The questionnaire included 8 questions on demographic data, surgical activity, outpatient clinics, and training suggestions. The results underwent a descriptive statistical analysis.</p><p><strong>Results: </strong>Eighteen residents participated (11 women and 7 men), with a mean age of 29.6 years; 61% were MIR-5 and 39% MIR-4. R4s perceived greater autonomy in frequent procedures (open orchidopexy, inguinal herniorrhaphy, appendectomy, and upper gastrointestinal endoscopy) and less in neonatal surgery and urological pathology. R5s reported greater independence in common general surgery and less in esophageal atresia, diaphragmatic hernia, pyeloplasty, and nephrectomy. In outpatient clinics, autonomy was greater in abdominal and skin pathology, and lower in urology and head and neck pathology. Among the main limitations noted were the low volume of neonatal surgery, the high number of residents, and the scarce offer of structured training activities.</p><p><strong>Conclusions: </strong>The lower perceived autonomy is concentrated in neonatal surgery and complex urological pathology. Coordinated training strategies are required at the national level, including surgical simulation, structured online training, and rotations in reference centers, to optimize the acquisition of competencies and ensure that training is as complete as possible.</p>","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"39 3","pages":"102-107"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564263","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":"Knowledge and level of implementation of \"Do Not Do\" recommendations in Spanish pediatric surgery departments.","authors":"A E Hernández, C Soto, Ó Girón, M de Diego","doi":"10.54847/cp.2026.03.13","DOIUrl":"10.54847/cp.2026.03.13","url":null,"abstract":"<p><strong>Objectives: </strong>In recent decades, initiatives have been developed to promote the de-implementation of low-value practices through \"do not do\" recommendations (RNH). This study aimed to estimate the level of awareness and the state of implementation of representative RNH in Pediatric Surgery Departments within the Spanish National Health System (SNS), as the initial phase of the NOCIPE project, endorsed by the Spanish Society of Pediatric Surgery (SECP).</p><p><strong>Material and methods: </strong>Observational, descriptive, cross-sectional study using a self-administered survey addressed to the heads of Pediatric Surgery departments within the SNS. Descriptive analysis and non-parametric comparisons for independent samples were performed.</p><p><strong>Results: </strong>A total of 16/37 (43%) responses were obtained. Among respondent centers, 9 (56.2%) reported having a clinical practice appropriateness entity, and 5 (31.2%) included RNH in management agreements. The median number of RNH assessed per center was 6.5/8 known (81%; IQR 3), 5/8 implemented (62%; IQR 4), and 1/8 measured (12%; IQR 1). No significant differences were observed in the number of implemented RNH according to the presence of an appropriateness entity or inclusion in management agreements. Nine additional RNH were collected and used as a complementary source in subsequent phases of the project.</p><p><strong>Conclusions: </strong>The findings reveal a significant gap between awareness, implementation, and particularly the measurement of RNH, highlighting the need to strengthen dissemination strategies, facilitate implementation, and standardize indicators and tools to assess their impact and guide comparable improvements across centers.</p>","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"39 3","pages":"97-101"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564212","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":"Surgical management of neonatal mastitis: case series and literature review.","authors":"L J Sánchez Pulido, G Solís Sánchez, C Calvo Penín, E Hortelano Romero, S E Olarte Ingaroca, C Pérez Costoya, D Crehuet Gramatyka, V Álvarez Muñoz","doi":"10.54847/cp.2026.03.17","DOIUrl":"https://doi.org/10.54847/cp.2026.03.17","url":null,"abstract":"<p><strong>Objectives: </strong>To describe the surgical experience in the management of neonatal mastitis and to review the relevant literature on its clinical and surgical management.</p><p><strong>Material and methods: </strong>A retrospective study of 16 cases treated at a tertiary care hospital between 2009 and 2024. Clinical, laboratory, microbiological, and surgical variables were collected.</p><p><strong>Results: </strong>Most patients were female, with a mean age at diagnosis of 17 days. Surgical drainage was required in 32% of cases, and Staphylococcus aureus was isolated in all of them. Cloxacillin and gentamicin were used as the treatment of choice. Clinical outcomes were favourable in most cases, with a low recurrence rate.</p><p><strong>Conclusions: </strong>Combined medical and surgical treatment is effective in complicated neonatal mastitis. Early diagnosis and a conservative surgical technique are key to achieving a favourable prognosis.</p>","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"39 3","pages":"120-123"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564230","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":"Experience of surgical management of ovarian masses in pediatrics in two pediatric hospitals in the city of Bogotá between 2019-2024.","authors":"N J Tinoco, H G Melgarejo, D I Mendoza, L Sotomayor, S Grazziani, A Casallas","doi":"10.54847/cp.2026.03.16","DOIUrl":"10.54847/cp.2026.03.16","url":null,"abstract":"<p><strong>Introduction: </strong>At the national level, there are no standardized protocols or management guidelines for pediatric patients with ovarian tumors. This situation has led to heterogeneous and variable approaches among different institutions, leading to invasive and oncological surgeries in patients with a high probability of presenting a benign pathology. The purpose of this study is to characterize patients with ovarian masses in two reference pediatric hospitals in the city of Bogotá, Colombia, in order to describe the clinical characteristics, the initial approach, the surgical management, and the final histopathology. This could represent the initial step toward creating standardized protocols in the future to improve decision-making regarding the management of these patients.</p><p><strong>Methods: </strong>A descriptive cross-sectional observational study was carried out in two reference pediatric institutions. A review of medical records was performed for the evaluation and analysis of demographic, clinical, paraclinical, surgical, and histopathological variables of patients under 18 years of age operated on with a diagnosis of ovarian tumor.</p><p><strong>Results: </strong>A total of 127 patients under 18 years of age were obtained, with an average age of 14 years. Abdominal pain was identified as the most frequent symptom. Likewise, it was evidenced that malignant tumors tend to have a larger size in ultrasound, tomography, and during intraoperative findings. On the other hand, the tumor markers most related to malignancy were AFP and β-hCG. Regarding surgical management, it was observed that benign pathology was mostly treated by laparoscopy with ovary-sparing surgery, while patients with suspected malignancy were treated by open surgery with oncological staging. The final histopathological result found 88% benign tumors, a percentage similar to that reported in current literature.</p><p><strong>Conclusions: </strong>The behavior and outcomes of ovarian pathology in the hospitals selected for the study were similar to those reported by global literature. Additionally, it was evidenced that there could be a relationship between tumor size, tumor markers, and the risk of malignancy. There is a growing trend toward performing less invasive surgeries; however, multicenter, prospective, and long-term studies are required to develop evidence-based management guidelines that help medical personnel make decisions to improve the approach for these patients.</p>","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"39 3","pages":"115-119"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564260","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":"Sacrococcygeal teratoma associated with complex gastroschisis with favorable outcome. A case report.","authors":"J Salsamendi, M Ormaechea, L Díaz, G Giannini","doi":"10.54847/cp.2026.03.18","DOIUrl":"10.54847/cp.2026.03.18","url":null,"abstract":"<p><strong>Introduction: </strong>We present the case of a newborn with sacrococcygeal teratoma and complex gastroschisis, complicated with intestinal perforation. This is an unusual association, with only 1 reported case worldwide, and this is the first reported case that survived with a good outcome.</p><p><strong>Clinical case: </strong>The treatment was conducted in 4 stages: gastroschisis closure and enterostomy delaying the treatment of the atresia, teratoma resection, correction of the atresia using the Santulli technique and closure of the stoma. It took 6 months and 18 days to complete the whole treatment. The patient showed excellent progress with good growth and subsequent development.</p><p><strong>Discussion: </strong>The treatment conducted in 4 stages made possible the resolution of each pathology, with proper assessment and surgical planning, making possible the patient's development and growth while minimizing the risks of complications.</p>","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"39 3","pages":"124-127"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564225","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":"Beyond surgery: Quality of life in survivors of sacrococcygeal teratoma.","authors":"A Madurga, J Abad, M V López Canelada, A Muñoz, S Barrena, A L Luis, L Martínez","doi":"10.54847/cp.2026.03.15","DOIUrl":"https://doi.org/10.54847/cp.2026.03.15","url":null,"abstract":"<p><strong>Background: </strong>Sacrococcygeal teratoma (SCT) is the most frequent congenital tumor in neonates. Despite excellent survival rates after early surgical resection, survivors may face significant long-term sequelae that affect health-related quality of life (HRQoL).</p><p><strong>Methods: </strong>We conducted an ambispective cohort study of all SCT patients treated at a tertiary pediatric hospital between 1995 and 2020. Clinical, surgical, and follow-up data were collected, and HRQoL was evaluated using the PedsQL 4.0 Generic Core Scales and Spinal Cord Injury Module, compared with age- and sex-matched controls.</p><p><strong>Results: </strong>We included 18 SCT patients treated at our center. HRQoL was evaluated in 12 patients. Median age at inclusion was 17.1 years. Complications occurred in 72.2% of patients, and recurrence in 27.7%. Functional sequelae included urinary (55.6%), digestive (46.2%), and neurological (23.1%) dysfunctions. HRQoL scores were significantly lower than controls (patients 73.1 vs 86.7; p= 0.002). Urinary dysfunction was the main determinant of impaired HRQoL, impacting physical, emotional, and social domains. The presence of associated congenital anomalies (61.1%) was also frequent.</p><p><strong>Conclusions: </strong>Although survival after SCT resection is excellent, functional morbidity remains high. Urinary dysfunction is the leading cause of reduced HRQoL. Long-term multidisciplinary follow-up -including urology, gastroenterology, and psychological support- and systematic HRQoL assessment are essential to optimize long-term outcomes in this population.</p>","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"39 3","pages":"108-114"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564161","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}