Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica最新文献_第2页

The role of contrast-enhanced ultrasound in the diagnosis of gastroesophageal reflux. 超声造影在胃食管反流诊断中的作用。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2026-01-15 DOI: 10.54847/cp.2026.01.12

C Parrondo Muiños, T Moratalla Jareño, M S Fernández Córdoba, L C Fernández Masaguer

{"title":"The role of contrast-enhanced ultrasound in the diagnosis of gastroesophageal reflux.","authors":"C Parrondo Muiños, T Moratalla Jareño, M S Fernández Córdoba, L C Fernández Masaguer","doi":"10.54847/cp.2026.01.12","DOIUrl":"https://doi.org/10.54847/cp.2026.01.12","url":null,"abstract":"Objective: To assess the use of contrast-enhanced ultrasonography in the diagnosis of gastroesophageal reflux and hiatal hernia, avoiding ionizing radiation.Material and methods: Seven contrast-enhanced esophagogastric ultrasound examinations were performed in children between 5 months and 3 years of age, 5 to evaluate gastroesophageal reflux and hiatal hernia, and 2 for gastroesophageal reflux. An ultrasound machine with specific software for contrast visualization, a multi-frequency probe, and sonographic contrast agent were used. Findings were correlated with upper gastrointestinal series in 4 cases.Results: Of the 7 patients, 4 were awaiting percutaneous endoscopic gastrostomy (2 with a nasogastric tube and 2 with vomiting, 1 of them also with a nasogastric tube), and the remaining three had undergone surgery: 1 for hypertrophic pyloric stenosis, another for esophageal atresia, both also with vomiting; and the last was a patient with percutaneous endoscopic gastrostomy and suspected gastroesophageal reflux disease. The following were observed: 2 cases without gastroesophageal reflux, 4 with mild reflux on ultrasound (1 while coughing and another while crying) but not on fluoroscopy, and 1 with massive reflux and hiatal hernia. No side effects were reported.Conclusions: Contrast-enhanced ultrasound allows confirming or ruling out the presence of GER and hiatal hernia. Its great advantage is the absence of ionizing radiation and the possibility of a real-time study, making it easier to detect reflux.","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"39 1","pages":"9-14"},"PeriodicalIF":0.0,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146000045","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

Conservative management of pediatric patients with solid organ injury after blunt abdominal trauma. Consensus sponsored by the Spanish Society of Pediatric Surgery. 小儿钝性腹部外伤后实体器官损伤的保守治疗。由西班牙儿科外科学会赞助的共识。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2026-01-15 DOI: 10.54847/cp.2026.01.14

J Jiménez Gómez, R Rojo Díez, J C Moreno Alfonso, S Santiago Martínez, C Ruiz Hierro, C Barceló Cañellas, C Leganés Villanueva, G Roberto Lorenzo, A Laín Fernández, R Gander, J Lluna González, J C de Agustín Asensio, A Prieto Campo, M Prada Arias, J R Gómez-Veiras

{"title":"Conservative management of pediatric patients with solid organ injury after blunt abdominal trauma. Consensus sponsored by the Spanish Society of Pediatric Surgery.","authors":"J Jiménez Gómez, R Rojo Díez, J C Moreno Alfonso, S Santiago Martínez, C Ruiz Hierro, C Barceló Cañellas, C Leganés Villanueva, G Roberto Lorenzo, A Laín Fernández, R Gander, J Lluna González, J C de Agustín Asensio, A Prieto Campo, M Prada Arias, J R Gómez-Veiras","doi":"10.54847/cp.2026.01.14","DOIUrl":"10.54847/cp.2026.01.14","url":null,"abstract":"Introduction: The treatment of choice in pediatrics for solid organ injuries resulting from blunt abdominal trauma is conservative management. However, in Spain, said management has proven to be heterogeneous and inconsistent with recent evidence. The Spanish Society of Pediatric Surgery (SECP) sponsored the development of this consensus document in the year 2024.Material and methods: After recruiting a group of experts, a bibliographic review was conducted using the systematic reviews from APSA, the ATOMAC group, and contributions from the experts themselves, to draft a series of initial suggestions. The experts, using the Delphi method, scored these (Likert scale) in different voting rounds until statistical stability in the responses was determined (Wilcoxon Test). Consensus was defined as agreement (scores 4-5) exceeding 70%.Results: Twelve experts from 11 centers were recruited, achieving gender parity. Seventeen suggestions were developed, organized into four key areas: PICU admission, discharge criteria and strict bed rest, analytical/radiological controls, and physical activity restriction. Statistical stability was reached after 2 scoring rounds, achieving consensus on 15 of the 17 suggestions, while it was not achieved regarding hospital discharge criteria and duration of strict bed rest.Conclusions: Through Delphi methodology, a consensus document on the conservative management of solid organ injuries was developed. Although consensus was not reached on key aspects such as discharge criteria and strict bed rest, this document aims to help homogenize clinical practice.","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"39 1","pages":"22-31"},"PeriodicalIF":0.0,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146000428","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

Surgical decision-making strategies in preterm neonates with necrotizing enterocolitis: A randomized controlled clinical trial. 新生儿坏死性小肠结肠炎的手术决策策略：一项随机对照临床试验。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2026-01-15 DOI: 10.54847/cp.2026.01.13

G Fernández Ortega, M D Martín De Saro, S A Cuevas Covarrubias, G C Morón García, L Plaza Benhumea

{"title":"Surgical decision-making strategies in preterm neonates with necrotizing enterocolitis: A randomized controlled clinical trial.","authors":"G Fernández Ortega, M D Martín De Saro, S A Cuevas Covarrubias, G C Morón García, L Plaza Benhumea","doi":"10.54847/cp.2026.01.13","DOIUrl":"10.54847/cp.2026.01.13","url":null,"abstract":"Introduction: Surgical necrotizing enterocolitis (NEC) is associated with high mortality. Bell's criteria may indicate surgery in late stages, leading to worse outcomes. Early identification of surgical candidates is necessary. Objective: To evaluate surgical decision-making strategies in neonates with NEC, comparing Bell's criteria versus the combined use of metabolic disorder components (MD7) and paracentesis.Material and methods: A randomized controlled clinical trial was conducted in perinatal hospitals (2022-2023), ClinicalTrials.gov identifier: NCT06035848. Preterm neonates with NEC were divided into a control group (CG): surgery determined by Bell's criteria, and an intervention group (IG): surgery indicated by MD7 and positive paracentesis. The primary outcome was mortality. Descriptive and inferential statistics, relative risk (RR), with 95% confidence interval (CI), and a p-value < 0.05 indicating statistical significance were used.Results: 117 patients participated (CG n = 56, IG n = 61). In surgical NEC, mortality was 32.1% in IG and 64.7% in CG (p = 0.034; RR = 2, 95% CI: 1.1-4.8). In the IG, surgery was performed early, with better outcomes for perforation, intestinal necrosis, and reoperation (p < 0.05). There were no complications derived from paracentesis, and there were 3 non-therapeutic laparotomies in the IG.Conclusions: The strategy based on MD7 and paracentesis was superior to Bell's criteria for guiding surgical decisions in preterm neonates with NEC, reducing mortality. The main limitation was a small number of non-therapeutic laparotomies, expected due to the greater sensitivity of the strategy.","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"39 1","pages":"15-21"},"PeriodicalIF":0.0,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146000058","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

Implementation of a safety protocol for removal of bars in the pectus excavatum. 漏斗胸内铁条移除安全规程的实施。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2026-01-15 DOI: 10.54847/cp.2026.01.11

J P Camacho, C Korzin, P A Lobos, G R Elmo

{"title":"Implementation of a safety protocol for removal of bars in the pectus excavatum.","authors":"J P Camacho, C Korzin, P A Lobos, G R Elmo","doi":"10.54847/cp.2026.01.11","DOIUrl":"https://doi.org/10.54847/cp.2026.01.11","url":null,"abstract":"Introduction: Extraction of bars during Minimally Invasive Repair for Pectus Excavatum (MIRPE) is susceptible to complications ranging from mild to severe. Objective: to compare the outcomes following the implementation of a Bar Extraction Safety Protocol (BESP) to determine its effectiveness in reducing complications.Material and methods: Retrospective comparative cohort study. Inclusion criteria: Patients who underwent bar removal from November 2013 to March 2024, in whom BESP was implemented, compared with a historical cohort operated on previously. Protocol includes: a) Preoperative measures: during implantation, use of smooth bars, a minimum of two bars with lateral stabilizers, sternal elevation; pre-removal: chest X-rays. b) Intraoperative measures: bilateral incisions, bar straightening, and \"safety string\" maneuver. c) Postoperative measures: 24-hour admission to the pediatric intensive care unit (PICU) and post-removal chest X-ray. Complications were classified using the Clavien-Dindo (C-D) system, focusing on clinically relevant ones (C-D ≥ II). Statistical analysis was performed using the chi-squared test (Stata v16).Results: Sixty-seven patients were included; 62 were male. Mean age at surgery: 17 years (range 14-24). Thirty patients (43 bars) operated on pre-BESP, 37 (81 bars) post-BESP. Pre-BESP bars were serrated; post-BESP bars were smooth. Bar dwell time was 27 months (IQR 23-33) pre-BESP and 24 months (IQR 23-25) post-BESP. Hospital stay was 1 day in both groups (maximum: 16 vs. 4 days). Clinically relevant complications occurred in 20% of pre-BESP patients and 0% post-BESP (p=0.048).Conclusions: Implementation of BESP significantly reduced complications after bar removal, improving safety during bar removal in the MIRPE.","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"39 1","pages":"4-8"},"PeriodicalIF":0.0,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146000434","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

Mediastinal teratoma as a cause of pleural effusion. 纵膈腔畸胎瘤是胸腔积液的原因。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2026-01-15 DOI: 10.54847/cp.2026.01.16

F Imaz, P Garrido, M Medin, S Fiorini, A Santangelo, P Marino, R Godoy

引用次数: 0

Median arcuate ligament syndrome: Successful laparoscopic management enhanced by indocyanine green fluorescence. 正中弓状韧带综合征：吲哚菁绿荧光增强腹腔镜成功治疗。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2026-01-15 DOI: 10.54847/cp.2026.01.17

F Ortiz, M Cadario, M Carreño, C M Pérez Espinosa, J Ruiz, J Kaplan, C Martín, V H Ayarzabal

{"title":"Median arcuate ligament syndrome: Successful laparoscopic management enhanced by indocyanine green fluorescence.","authors":"F Ortiz, M Cadario, M Carreño, C M Pérez Espinosa, J Ruiz, J Kaplan, C Martín, V H Ayarzabal","doi":"10.54847/cp.2026.01.17","DOIUrl":"https://doi.org/10.54847/cp.2026.01.17","url":null,"abstract":"Introduction: Median arcuate ligament syndrome (MALS) is a rare vascular disorder characterized by compression of the celiac artery by the median arcuate ligament, resulting in variable clinical presentations, including abdominal pain.Case report: A 16-year-old female patient presented with chronic abdominal pain, recurrent vomiting, and weight loss over seven months. Doppler ultrasound showed increased peak systolic velocity in the celiac artery (331 cm/s) exacerbated during expiration and computed tomography angiography confirmed celiac artery compression with the typical \"J-hook\" deformity. She underwent successful laparoscopic surgical decompression assisted with indocyanine green fluorescence to confirm adequate perfusion of the celiac territory. Pre and postoperative quality of life was assessed using PedsQL scores, showing significant improvement. After a six-month follow-up, the patient remains asymptomatic.Conclusion: This case highlights the importance of considering MALS in the differential diagnosis of chronic abdominal pain in adolescents and reinforces the established efficacy and safety of laparoscopic management for MALS.","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"39 1","pages":"41-45"},"PeriodicalIF":0.0,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146000437","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

PedIAtric Surgery: Artificial Intelligence and the new horizon in Science. 儿科外科：人工智能和科学的新视野。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2026-01-15 DOI: 10.54847/cp.2026.01.10

B Núñez García

引用次数: 0

Ankyloglossia and frenotomy in Spain: assessment by the pediatric surgeon. 西班牙的强直性咬合和截骨术：由儿科外科医生评估。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2026-01-15 DOI: 10.54847/cp.2026.01.18

I Carrillo Arroyo, C Rico Espiñeira, M Rico Jiménez, H Souto Romero, J L Alonso Calderón

引用次数: 0

Low-cost simulation model for the treatment of inguinal hernia in pediatric patients. 小儿腹股沟疝治疗的低成本模拟模型。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2025-10-22 DOI: 10.54847/cp.2025.04.12

R Ramírez Díaz, A Sáenz Dorado, C Martínez Paz, L S Gallego, R I Cavaco Fernandes, J Bueno Recio

{"title":"Low-cost simulation model for the treatment of inguinal hernia in pediatric patients.","authors":"R Ramírez Díaz, A Sáenz Dorado, C Martínez Paz, L S Gallego, R I Cavaco Fernandes, J Bueno Recio","doi":"10.54847/cp.2025.04.12","DOIUrl":"https://doi.org/10.54847/cp.2025.04.12","url":null,"abstract":"Introduction: Open inguinal herniorrhaphy is the most widely used inguinal hernia repair treatment in pediatric surgery. Understanding the anatomy of the inguinal canal is essential to conduct this procedure.Material and methods: A low-cost, easily reproducible model aimed at training residents was designed to simulate open inguinal herniorrhaphy in children. It simulated the presence of inguinal hernia using low-cost materials such as balloons, transparent dressings, materials simulating the cremaster muscle, and cord elements. The model was validated by 4 pediatric surgeons and built by residents, who completed a post-simulation survey using the Likert scale. The survey assessed general aspects such as usefulness, texture, or grade of recommendation for regular training.Results: The surgical technique was completed step-by-step in the simulation model by a total of 10 pediatric surgery residents from various Spanish hospitals. Scores of 4.5/5 in general aspects, 4/5 in texture, 4.7/5 in usefulness, and 4.6/5 in grade of recommendation were achieved.Conclusions: We believe this low-cost, easy-to-build model stands as a useful tool both for surgical training and for understanding the anatomy of the inguinal canal in training residents.","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"38 4","pages":"143-146"},"PeriodicalIF":0.0,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145472628","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

Comparison of machine learning models in the interpretation of barium enemas in Hirschsprung's disease. 机器学习模型在巨结肠病钡灌肠解释中的比较。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2025-10-22 DOI: 10.54847/cp.2025.04.13

P Vargová, A González Esgueda, R Fernández Atuan, B Izquierdo Hernández, C Gutiérrez Alonso, Y González Ruiz, P Bragagnini Rodríguez, A Santiño Tenorio, C Corona Bellostas

{"title":"Comparison of machine learning models in the interpretation of barium enemas in Hirschsprung's disease.","authors":"P Vargová, A González Esgueda, R Fernández Atuan, B Izquierdo Hernández, C Gutiérrez Alonso, Y González Ruiz, P Bragagnini Rodríguez, A Santiño Tenorio, C Corona Bellostas","doi":"10.54847/cp.2025.04.13","DOIUrl":"https://doi.org/10.54847/cp.2025.04.13","url":null,"abstract":"Objective: To assess the diagnostic accuracy of machine learning models and ChatGPT in the interpretation of barium enemas for Hirschsprung's disease (HD), and to compare performance with that of pediatric radiologists.Material and methods: A retrospective study of the barium enemas of patients < 15 years of age managed at a tertiary institution from 2011 to 2023 was carried out. The images were used to train AI models and divided into training, validation, and test ensembles. Performance was assessed in a separate test ensemble with anonymized images, while calculating sensitivity, specificity, and ROC curves vs. final diagnosis, and it was compared with radiologists' performance.Results: 266 barium enemas from 218 patients (1,439 images in total) were included. The test ensemble consisted of 54 enemas, with 11 HD positive cases. The support vector model had a sensitivity of 72.7% and a specificity of 93%. The logistic regression model had an AUC-ROC of 0.73, with better results in anteroposterior than in lateral images. When compared with retrospective radiological reports, AI models had a classification capacity similar to that of expert professionals, with a sensitivity of 81% and a specificity of 76%.Conclusions: AI models showed potential in supporting the diagnosis of Hirschsprung's disease based on barium enemas, with a good capacity to rule out HD. This could improve diagnostic accuracy, especially in environments with little experience or limited availability of specialist radiologists. However, further studies are required to optimize clinical application.","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"38 4","pages":"147-152"},"PeriodicalIF":0.0,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145472630","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