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

{"title":"Conservative treatment of superior mesenteric artery syndrome.","authors":"M Martínez Díaz, M Couselo Jerez, E Valdés Diéguez, V Ibáñez Pradas","doi":"10.54847/cp.2025.04.10","DOIUrl":"https://doi.org/10.54847/cp.2025.04.10","url":null,"abstract":"<p><strong>Objective: </strong>To assess predictive factors for failure in the conservative treatment of patients with superior mesenteric artery syndrome (SMAS).</p><p><strong>Material and methods: </strong>A retrospective case-control study was carried out. Cases included pediatric patients diagnosed with SMAS and treated in our institution from 2013 to 2024. Controls included surgically treated SMAS patients under 20 years of age from a PubMed bibliographic review. Of a total of 205 papers, 24 met inclusion criteria. Demographic, clinical, diagnostic, therapeutic, and progression variables were collected. Statistical analysis was performed using chi-square/Fisher and Mann-Whitney U tests.</p><p><strong>Results: </strong>N= 42 (16 cases and 26 controls). No statistically significant differences were found in terms of BMI (17.25 vs. 14.43; U= 148.5; p= 0.398), progression time (130 vs. 90 days; U= 176.0; p= 0.820), angle (19° vs. 14.1°; U= 159.0; p= 0.206), or aortomesenteric distance (3.5 cm vs. 4.25 cm; U= 62.5; p= 0.068). Cases received conservative treatment, except for one who refused this treatment modality. There were no significant differences regarding final BMI (18.6 vs. 17.9; U= 96.0; p= 0.560), treatment success, or hospital stay (7.0 vs. 6.0 days; U= 168.0; p= 0.308) between both groups.</p><p><strong>Conclusions: </strong>Conservative treatment is highly successful regardless of progression time, BMI, angle, and aortomesenteric distance. Therefore, surgery is not recommended as the first option in the management of SMAS.</p>","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"38 4","pages":"130-136"},"PeriodicalIF":0.0,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145472626","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":"Management of nephrogenic adenoma in pediatric patients with multiple urological interventions.","authors":"C Pérez Costoya, C Granell Suárez, V Álvarez Muñoz, A Gómez Farpón","doi":"10.54847/cp.2025.04.16","DOIUrl":"https://doi.org/10.54847/cp.2025.04.16","url":null,"abstract":"<p><strong>Introduction: </strong>Nephrogenic adenoma (NA) is an extremely rare benign tumor in children that may be misdiagnosed as malignant.</p><p><strong>Case report: </strong>An 8 years-old male with history of previous pyeloplasty and bilateral ureteral reimplantation that during follow-up presented with an excrescent asymptomatic lesion in the bladder. A cystoscopy to take biopsies was performed, consistent with a metaplastic lesion or NA. Finally, a partial cystectomy was conducted and confirmed the diagnosis of a NA. No recurrence has been observed after 5 years of follow-up.</p><p><strong>Discussion: </strong>NA is a rare condition, but it must be considered in the differential diagnosis of urinary tract tumors specially in patients with previous urological procedures. It can appear as an incidental finding, but the elective treatment is resection. Malignant transformation has been described in adults. Besides, recurrence rates are quite high in pediatric patients, so long-term follow-up is mandatory.</p>","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"38 4","pages":"163-166"},"PeriodicalIF":0.0,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145472637","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":"Primary pneumomediastinum in pediatric patients: are hospitalizations and control x-rays necessary?","authors":"A C Moore Olalla, Y P Álvarez Marchán, J Jiménez Gómez, J E Betancourth Alvarenga, S Santiago Martínez, M B San Vicente Vela, J R Güizzo Tobares, P Jiménez Arribas, A Castrillo Arias, B Sánchez Vázquez, M Gaspar Pérez, C Esteva Miró, N Álvarez García, B Núñez García","doi":"10.54847/cp.2025.04.09","DOIUrl":"10.54847/cp.2025.04.09","url":null,"abstract":"<p><strong>Objective: </strong>Primary pneumomediastinum (PP) is an infrequent condition in pediatrics with no standardized management. The objective of this paper was to report our experience with PP and analyze the role of hospitalizations and radiological tests.</p><p><strong>Material and methods: </strong>A retrospective study of pediatric patients with PP from 2013 to 2023 was carried out. Demographic, clinical, and radiological data was collected.</p><p><strong>Results: </strong>24 patients (54% of whom male) with a median age of 9.5 years (3.9-15.2) and a median weight of 32 kg (14.8-49.3) were included. The most frequent reasons for consultation were dyspnea (46%), chest pain (29%), and odynophagia (13%). Patients < 5 years old reported less chest pain (12.5% vs. 75%, p= 0.008) and had more respiratory infections (p= 0.032), with lower SpO2 (95% vs. 98.5%, p= 0.05). 19 (79%) patients required hospitalization, 9 of whom exclusively as a result of PP. Hospitalization was longer (5.5 vs. 3 days, p= 0.017) and aerosol treatment was more frequent (p= 0.005) in patients admitted due to concomitant pathologies. They all received conservative treatment. Early (< 24 h) pain control was achieved with oral analgesia, without complications or rehospitalizations in the first 30 days following discharge. Additional radiological tests, aside from the diagnostic chest X-ray, were carried out in 95.8% of the cases (95.8% X-rays, 12.5% chest CT-scan), with no changes in terms of patient management whatsoever. Subcutaneous emphysema was not significantly associated with more X-rays (3 vs. 1.5, p= 0.235). Median added radiation was 0.05 mSv (0.02-0.1) or 2.5 X-rays.</p><p><strong>Conclusions: </strong>PP is a benign condition that can be conservatively treated. In the absence of intercurrent pathologies, hospitalization might prove unnecessary. Additional ionizing tests increase radiation while not adding a clear clinical benefit.</p>","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"38 4","pages":"123-129"},"PeriodicalIF":0.0,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145472636","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":"Minimally invasive treatment of splenic cysts in pediatric patients.","authors":"A Santángelo, J Udaquiola, F Rabinovich, H Bignón","doi":"10.54847/cp.2025.04.11","DOIUrl":"https://doi.org/10.54847/cp.2025.04.11","url":null,"abstract":"<p><strong>Introduction: </strong>Non-parasitic splenic cysts (NPSC) are a rare entity in the pediatric population. Surgical treatment remains controversial, with splenic function preservation being a key objective. We present our experience with the treatment of NPSC in pediatric patients through laparoscopic unroofing and omentoplasty, while assessing short- and long-term results.</p><p><strong>Material and methods: </strong>A retrospective study of 12 pediatric patients with NPSC treated with laparoscopic unroofing and omentoplasty from 2000 to 2024 was carried out. Demographic, clinical, and surgical variables, as well as short- and long-term results, were analyzed.</p><p><strong>Results: </strong>Mean age was 11 years. 67% of the patients were female. No intraoperative or postoperative complications were recorded. Median follow-up was 18 months. 2 patients (17%) had a persistent cyst, but they remained asymptomatic and under follow-up. No recurrences were noted.</p><p><strong>Conclusions: </strong>Laparoscopic unroofing and omentoplasty is a viable and safe technique for the treatment of NPSC in pediatric patients, with acceptable recurrence rates and less morbidity. This technique can be an effective option to preserve splenic function and reduce the risk of complications. Further studies with a long-term follow-up are required to confirm these results.</p>","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"38 4","pages":"137-142"},"PeriodicalIF":0.0,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145472632","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":"Pediatric targeted cervical lymph node excision using ultrasound-guided tracer injection and intraoperative portable gamma camera.","authors":"J Arredondo Montero, S López Iniesta, M Rodríguez Ruiz, A I Sevilla Miguélez","doi":"10.54847/cp.2025.04.15","DOIUrl":"10.54847/cp.2025.04.15","url":null,"abstract":"<p><strong>Introduction: </strong>Excision of cervical lymph nodes in children can be technically demanding when nodes are small or deeply located. Combining ultrasound-guided tracer injection with an intraoperative portable gamma camera allows functional guidance during surgery.</p><p><strong>Case report: </strong>A pediatric patient with persistent unilateral cervical lymphadenopathy underwent ultrasound-guided injection of a technetium 99mTc-labeled tracer. In the operating room, the portable gamma camera identified focal uptake and guided a targeted nodal excision through a limited cervical approach. The specimen was obtained safely, the procedure was uneventful, and recovery was rapid.</p><p><strong>Discussion: </strong>The use of ultrasound-guided tracer deposition combined with an intraoperative portable gamma camera provided precise, real-time navigation for pediatric lymph node excision. This approach may help reduce the extent of dissection and operative time while maintaining safety. It represents a feasible adjunct for selected pediatric cervical procedures.</p>","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"38 4","pages":"159-162"},"PeriodicalIF":0.0,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145472651","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":"Prognostic factors in the endoscopic treatment of vesicoureteral reflux.","authors":"C Pérez Costoya, A Gómez Farpón, M J Martínez Urrutia, V Álvarez Muñoz, C Granell Suárez","doi":"10.54847/cp.2025.04.14","DOIUrl":"https://doi.org/10.54847/cp.2025.04.14","url":null,"abstract":"<p><strong>Objective: </strong>The role of endoscopic treatment in the management of vesicoureteral reflux (VUR) remains controversial. This study aims to identify the prognostic factors of endoscopic treatment success for VUR repair.</p><p><strong>Material and methods: </strong>A retrospective, analytical study of patients -expressed as ureteral units (UU)- with endoscopically treated congenital VUR from 2000 to 2020 was carried out. Follow-up was maintained for 5 years after the last treatment, with clinical and radiological controls. Treatment success was defined as the absence of VUR at postoperative cystourethrography.</p><p><strong>Results: </strong>167 UUs were treated, 80% of which had high-grade VUR (III-V). Overall endoscopic treatment success was 92.8%. 90.9% of low-grade VUR cases were resolved in the first procedure. The poor prognosis factors identified included high-grade VUR (p= 0.02), early age at treatment (p= 0.001), and preoperative anteroposterior diameter of the renal pelvis (p= 0.001). 23% had other urological malformations; no statistical relationship as a poor prognosis factor was found (p= 0.08), but up to 45% required more than one treatment.</p><p><strong>Conclusions: </strong>The endoscopic approach is effective for VUR treatment, especially in low-grade VUR cases. High-grade VUR and early age at surgery are poor prognosis factors. The association with other urological malformations does not reduce treatment success.</p>","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"38 4","pages":"153-158"},"PeriodicalIF":0.0,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145472633","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":"Eponyms for Hirschsprung's disease.","authors":"Ó Girón-Vallejo","doi":"10.54847/cp.2025.03.11","DOIUrl":"https://doi.org/10.54847/cp.2025.03.11","url":null,"abstract":"","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"38 3","pages":"85-90"},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692938","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":"Transcultural adaptation and validation of the Pectus Carinatum Body Image Quality of Life Questionnaire (PeCBI-QOL) into Spanish.","authors":"J V Redondo Sedano, A Gómez Sánchez, V A García-Tabernero Hernández, C Martín-Arriscado Arroba, A Gómez Fraile, M D Delgado Muñoz","doi":"10.54847/cp.2025.03.12","DOIUrl":"https://doi.org/10.54847/cp.2025.03.12","url":null,"abstract":"<p><strong>Introduction: </strong>The primary objective was to conduct the translation and subsequent transcultural adaptation into Spanish of the Pectus Carinatum Body Image Quality of Life questionnaire (PeCBI-QOL), designed to assess Pectus Carinatum (PC)'s quality of life impact.</p><p><strong>Material and methods: </strong>A translation and transcultural adaptation process was carried out according to WHO guidelines. The process consisted of the following steps: direct translation, Delphi pilot study, retro-translation, cognitive survey to patients, and analysis/validation.</p><p><strong>Results: </strong>42 patients and their respective caregivers replied to the validation questionnaire. Principal component factor analysis of the patient questionnaire showed a 4-factor solution, whereas in the caregiver questionnaire, it showed a 3-factor one. The questionnaires demonstrated good reliability, with internal consistency alpha coefficients of 0.78 and 0.85, respectively. The subscale-based concordance analysis also revealed good results in terms of reliability, except for the Motivation/treatment adhesion subscale in the patient questionnaire.</p><p><strong>Conclusion: </strong>The Spanish version of the PeCBI-QOL questionnaire is valid and reliable for assessing PC's impact on patients' body image and quality of life.</p>","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"38 3","pages":"91-99"},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692943","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":"Laparoscopic approach of anorectal malformations: Have we learnt anything in the past 10 years?","authors":"J C de Agustín Asensio","doi":"10.54847/cp.2025.03.10","DOIUrl":"https://doi.org/10.54847/cp.2025.03.10","url":null,"abstract":"","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"38 3","pages":"83-84"},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692941","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":"Intraoperative radiotherapy in the local control of chest wall Ewing sarcoma.","authors":"S Monje Fuente, A Del Cañizo López, J Ordóñez Pereira, M A García-Casillas, L Pérez Egido, I Bada Bosch, J Bueno Romero, J Cerdá Berrocal, M De La Torre Macías, E Cela De Julián, C González San Segundo, J C De Agustín Asensio","doi":"10.54847/cp.2025.03.13","DOIUrl":"https://doi.org/10.54847/cp.2025.03.13","url":null,"abstract":"<p><strong>Introduction: </strong>Ewing sarcoma is a rare malignant tumor with an incidence of 3 cases per 1 million inhabitants annually. Cross-disciplinary management is key to improve survival rates. The role played by intraoperative radiotherapy in terms of treatment is still to be defined.</p><p><strong>Material and methods: </strong>A retrospective study of pediatric patients (up to 16 years of age) with chest wall Ewing sarcoma undergoing tumor resection surgery, intraoperative radiotherapy, and chest wall reconstruction in our institution from 2011 to 2024 was carried out. Variables such as age at surgery, sex, neoadjuvant treatment, resection type, characteristics of intraoperative radiotherapy, reconstruction type, complications, local control rate, relapses, survival, and reconstruction's functional result were collected.</p><p><strong>Results: </strong>8 patients were included. Mean age at diagnosis was 12.5 years. Full tumor mass removal with free margins (R0) was achieved in 100% of the cases. Reconstructive techniques with flexible patches, titanium plates, and muscle flaps were used. None of the flaps was lost. Overall survival was 87.5%, with a mean follow-up period of 6 years. 3- and 5-year overall survival rates were 100% and 80%, respectively. Local control of the disease was achieved in 100% of the cases.</p><p><strong>Conclusions: </strong>This paper discusses the role of intraoperative radiotherapy as a good treatment alternative to achieve the local control of Ewing sarcoma associated with large surgical resections.</p>","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"38 3","pages":"100-105"},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692940","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}