[Cancellations in pediatric surgery]. / Cancelaciones en cirugía pediátrica.

UNLABELLED: Cancellations have an important role in the effectiveness of the surgical schedule. OBJECTIVE: Analyze the evolution of the cancellations during the years 1994-1997, after institution of several corrective measures. MATERIAL AND METHOD: We started in 1994 together with the Quality Unit of the Hospital, a program to reduce surgical cancellations. It consisted in improvement of parents information, surgical schedule centralization, and increasing the awareness of the importance of constant improvement. Cancellations have been divided in: inevitables and inevitables, and analyzed for the entire Service and for each speciality. RESULTS: A significant reduction of cancellations have been obtain (from 12.38% in 1992 to 3.35% in 1997). The inevitable causes (no presentation, inadequate preparation and lack of time in the surgical room) have shown the most improvement. Although the inevitable causes (intercurrent disease) were also significantly improved, after obtaining prior information of the health of the child, by telephone call or parents advise. ENT is the speciality with greatest improvement by significant reduction of the non presentation and intercurrent disease. CONCLUSION: After corrective measures conjointly with a realistic surgical schedule, prior telephone call and improvement quality concept, have permitted a significant reduction of cancellations.

[Digestive intolerance in newborn infants with extensive intestinal resections. Nutritional problems and long-term sequelae]. / Intolerancia digestiva en neonatos con grandes resecciones intestinales. Problemas nutricionales y secuelas a largo plazo.

The experience of two neonates with extensive intestinal resection and severe difficulties in the introduction of oral nutrients in presented. The pathophysiology and treatment of short bowel syndrome is reviewed, emphasizing the importance of maintenance of nutritional support as well as the factors that contribute to the readaptation mechanism. Mention is made of the complications and long-term sequelae encountered in these cases, whose body weights and growth were normal at the age of 5.

[Follow-up of essential fatty acids in parenteral nutrition in which a fat preparation is included]. / Seguimiento de los ácidos grasos esenciales a lo largo de la alimentación parenteral, en la que se incluye un preparado graso.

Changes in essential fatty acids of twenty two patients during parenteral nutrition are studied. Two populations (neonatal and others) were differencied. In the neonatal group a percentual decrease in arachidonic acid was showed. In both groups a percentual increase of linoleic acid was observed. Possible implications of these findings are discussed.

[Necrotizing enterocolitis and its surgical management. Study of 35 cases]. / Enterocolitis necrotizante. Consideraciones sobre su tratamiento quirúrgico. Estudio de 35 casos.

Thirty five cases of necrotizing enterocolitis, seen in the past five years in this clinic, are reviewed. Twenty four cases were seen up to December 1977 and eleven cases from January to March 1978 due to a neonatal I.C.U. epidemy. The relationship between some of the accepted perinatal pathogenic factors and the development of necrotizing enterocolitis is analyzed. The temporal relationship of the time of diagnosis to the onset of treatment is an important consideration for the prognosis. We propose surgical treatment if after eighteen hours of treatment there is no improvement. A guideline for the early treatment and surgical indications of acute necrotizing enterocolitis, is suggested.