[One-step low profile percutaneous endoscopic gastrostomy: our experience in children]. / Gastrostomía percutánea endoscópica con colocación de botón en un solo tiempo: nuestra experiencia en niños.

OBJECTIVES: Percutaneous endoscopic gastrostomy (thu) is the preferred method for the placement of a gastrostomy in children. In recent years a system to perform a button gastrostomy in one step has been designed (PEG-B). This system offers advantages over classical PEG although the potential risk of complications is greater. The aim of this paper is to present our experience with PEG-B. METHODS: . Retrospective review of pediatric patients who have received the PEG-B system during 2013 in Hospital Universitario Son Espases, Pamna de Mallorca. Parameters analyzed included demographics, indications, feeding start, length of hospital stay and complications. RESULTS: . A total of 8 patients, aged 8 months to 14 years, were included in the study. Indications were neurologic disease in 4 patients, metabolic disorders in 3 and tumors in 1. The weight range was 5.5 to 36 kg with a median of 12.4 kg. 16 Fr buttons were placed with length adjusted to each patient. The use of the gastrostomy started between 4-48 hours. The average length of hospital stay was 43.5 hours (24h-72h). There have been no major complications in 6 months follow up. A single pneumoperitoneum occurred postoperatively and two granulomas, one of them at one of the anchor points of the gastrostomy. CONCLUSIONS: Although it is a small series, no major complications were found and results are comparable to results published in the surgical literature in both techniques. We believe that the PEG-B is a good choice for PEG placement in children.

Masa infraclavicular / Infraclavicular mass

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[Neuroblastoma with bone marrow invasion. A multicenter study. Work Group of the Spanish Society of Pediatric Surgery]. / Neuroblastomas con médula ósea invadida. Estudio multicéntrico. Grupo de Trabajo de la Sociedad Española de Cirugía Pediátrica.

By means of a retrospective study made of multiple centres, it was aimed to determine which variables could be influential at the moment of diagnosis in the prognostic of patients suffering neuroblastoma and medullary bone affection. Fifty four cases of patients belonging to a total of ten hospital centers have been revised in a period of five years. The ages under study spanned from three months to eight years of age (mean = 2.83 years). For the analysis of the patients, they were divided into two groups: one being composed of the deceased patients and the other of the surviving. The deceased patients were of a more advanced age, the delay in the diagnosis was greater, the primitive tumor was found to be more frequently located in the adrenal glands, the metastasis appeared more readily in multiples, and the effectiveness of the treatment was less, resulting in lower cases of remission and a less radical surgery. The only difference with respect to other publications is that in the case of surviving patients, the number of cases of enolase and ferritin is more frequently pathological.