[Cholecystolithotomy: first middle-long term results of our series]. / Colecistolitotomía: primeros resultados a medio-largo plazo de nuestra serie.

UNLABELLED: Cholelithiasis in children is an infrequent disease whose incidence has increased over the last few decades. It has its own typical characteristics, different from those present in adults. Laparoscopic cholecystectomy has become the treatment of choice for symptomatic cases, still its connection with right-sided colon cancer and other diseases associated with the procedure has led to recommend it with some reservation. Though several authors adopted cholecystotomy as a therapeutic option in recent years, its use remains controversial. Our indication criteria for this technique are presented herewith, as well as long- and medium-term results (mean follow-up of 10 years) of our series, previously reported in 2003, and a new case added later in 2006. MATERIALS AND METHODS: Since 2003, a prospective study of 15 patients from our previous series and a new patient added afterwards is being carried out, including: 1) Medical history checking for symptoms connected with biliary conditions. 2) DIAGNOSTIC TESTS: laboratory tests and ultrasonography. RESULTS: Out of our 16 patients: A girl relapsed a few months later and underwent cholecystectomy, but whether it was a true relapse or a missed gallstone was not established. A patient with a history of recurrent abdominal pain has shown no improvement in his symptoms even though his tests are normal. Two patients have been lost for our study, but showed normal tests for 5 and 7 years respectively. Our 11 remaining patients show no symptoms as well as normal laboratory and imaging tests. A new patient joined our study in 2006, showing normal tests to date and no postsurgical complications. CONCLUSIONS: Based on our experience, cholecystotomy has proved to be a complication-free, safe and easy procedure with a virtually nonexistent relapse rate in the long and medium term for patients in the pediatric age group presenting with single or double cholelithiasis, unchanged for 1-2 years with no size increase, no apparent etiology, no complications and a normal bile duct.

[Complete lower urinary tract duplication with true diphallia associated to anorrectal and neural malformations]. / Duplicación completa del tracto urinario bajo con difalia verdadera y otras anomalías asociadas.

We report a case of complete urinary tract duplication with true diphallia associated to intestinal and neural anomalies. Complete penile duplication with hypospadias and bifidum scrotum were showed. Moreover, he had got anorrectal disease (anterior anus) and neural tube defects (myelomeningocele). Radiological and functional studies were performed and complete duplication lower urinary tract with coordinate miction were found. Combined surgical approach were used: perineal to remove lateralized and hypospadic penile and abdominal for cystoplasty. We report a case due to the extremely low prevalence. Only 15 cases have been described in the literature.

[Nonsurgical correction of congenital auricular deformities a new method of neonatal molding and splinting]. / Tratamiento no quirúrgico de las deformaciones auriculares. Una nueva técnica de modelado y ferulización auricular en el período neonatal.

INTRODUCTION: The utility of the nonsurgical correction of congenital auricular deformities by ear molding and splinting has been previously established. Occasionally, its application cannot be easy, and the later collaboration of the parents is necessary. We report a new method of splinting that simplifies the procedure. DESIGN: prospective, case series. PATIENTS AND METHODS: Twenty ears in 15 patients between 7 and 60 days of age (average 22 days) were treated. They were 12 prominent ears, 4 Stahl's ears, 2 lop ears, 1 Crinkled ear, and 1 case of increase of antihelix folder. Cotton impregnated with 2-Octyl-Cyanoacrylate is placed as splint for 6 weeks. RESULTS: The bilateral application lasted less than 5 minutes, end there were no spills to the external auditory canal. The splint was given off to the 2 weeks, and a second procedure was necessary in all the cases. There were no dermatitis or skin ulcers. The treatment was successful in 11 cases, partial improvement in 3, poor correction in 4, and recurrence in 2. CONCLUSIONS: The splint therapy is an easy nonsurgical method for the treatment of congenital auricular deformities that applied during the first weeks of life provides good aesthetic results in more than 50% of the patients.

[Anterior approach otoplasty for treatment of prominent ears in children. A minimally invasive technique]. / Otoplastia por vía anterior para el tratamiento de las orejas prominentes. Una técnica mínimamente invasiva.

INTRODUCTION: In adult patients, it has been reported that prominent ears can be treated by mattress sutures placed through the anterior aspect of the ear, with a minimally invasive technique. In order to verify the utility of this method in children, we used this technique in our patients. MATERIAL AND METHODS: Twenty-two prominent ears were treated in 12 patients between 8 and 11 years of ages. All were operated under general anesthesia. The anterior surface of the auricular cartilage is scored with a rasp. The antihelix shape is obtained, and mattress sutures are placed through the anterior surface of the ear. RESULTS: A good aesthetic result was obtained in all the cases. Superficial skin necrosis happened in three. Partial loss of correction in the superior pole was noted in four ears. In 6, some knots were visible through the skin. CONCLUSIONS: This repair is a simple technique for the treatment of the prominent ears in children, of good aesthetic results, that it avoids the necessity of dorsal skin resection and produces folds of antihelix more naturally curved. In children, to avoid the exteriorization of the suture material, the knots must be placed in the posterior surface of de auricular cartilage.