Cirugía pediátrica : organo oficial de la Sociedad Española de Cirugía Pediátrica
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Ovarian torsion presents low incidence in children and unspecific clinical presentation, therefore the diagnostic delay is rather common. Traditionally, necrotic appearance has been synonymous of oophorectomy, however the current trend defends ovary preservation. We present our experience in conservative management of ovarian torsion. ⋯ Laparoscopic conservative management with untwisting the ovary, allows that macroscopically nonviable ovaries could be recovered. However, an exhaustive and long-term follow-up is required to confirm the outcome.
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The ingestion of foreign bodies is a common trouble in the pediatric population, and most of cases occur between 6 months and 3 years. In general the vast majority of foreign bodies are not associated with morbidity or mortality. Ingestion of two or more magnets can lead to obstruction, fistulas, ulceration, perforation and bowel volvulus. In this series we present 4 cases of patients ingesting multiple magnets and who due to the ingested foreign body characteristics and clinical profile required surgical treatment.
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Extracorporeal membrane oxygenation (ECMO) is a rescue therapy for reversible respiratory or cardiac diseases. Neonatal pathologies requiring this technique are different from the ones found later in life. ⋯ Survival among newborns supported with ECMO in our hospital is similar to that recorded by the ELSO in 2004, although we use veno-venous cannulation in more than a half of the patients. The percentage of moderate to severely impaired neurodevelopmental outcome among survivors after this technique was low.
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Thanks to the generalization of minimally invasive surgery in pediatric patients some classic techniques are being replaced. Inguinal hernia repair may be an example. ⋯ Percutaneous laparoscopic assisted herniotomy is an effective, simple and feasible option for inguinal hernia in chidren without a high rate of complications.
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Comparative Study
[Subcutaneously inserted central intravascular devices in the pediatric oncology patient: can we minimize their infection].
Long-term indwelling central venous access devices are frequently used in pediatric patients. Their main complication is infection, that can even mean their removal. We try to identify the risk factors really involved in this complication and in their removal. ⋯ Related to early infection the only associateon founded was with the subclavian access (p=0.018). In conclusion, in our serie long-term central venous access infection was more frequent in the younger patients and also in those who had received chemotherapy the week before the catheter implantation. The tendency towards infection in leukemia, transplanted and subclavian carriers has to be studied in a prospective way with a larger number of oncologic children.