Use of a Bipolar Device (LigaSure) to Seal the Appendiceal Stump in Pediatric Laparoscopic Appendectomy: 10-year Latin-American Experience.

BACKGROUND: Closure of the appendiceal stump is a critical step during an appendectomy. There is a lack of knowledge about the feasibility of using electrosurgical devices for the occlusion of the appendix. This study aims to determine the safety of this technique in pediatric patients. METHODS: We performed a cross-sectional analytical study in patients less than 18 years of age treated at Hospital Militar Central Colombia between 2012 and 2021. Our institution's ethics committee approved the study. We analyzed the data using SPSS 22 statistical program. We present frequencies for qualitative variables and measures of central tendency or dispersion for quantitative variables depending on the distribution measured by the Kolmogorov-Smirnov test. In addition, we measured the association of nominal variables with the Chi-square test or Fisher's exact test. For numerical variables, the difference of means with the Student's t-test or the difference of medians with the Mann-Whitney U test. RESULTS: We treated 209 patients. One hundred sixteen (55.5%) were boys, and the mean age was 9.7 years (SD 3.2). The median intraoperative time was 60 min, and the hospital stay was 2.8 days on average. There were no cases of stump leakage, and only two patients (1%) had an organ-space surgical site infection, which was unrelated to the closure technique. We found no association between procedural complications and appendicular status (p = 0.450). CONCLUSIONS: Our research suggests that using a bipolar sealing device (Ligasure, Medtronic, USA) for appendiceal stump closure in pediatric patients undergoing laparoscopic appendectomy is feasible and should be further studied. TYPE OF STUDY: Treatment study. LEVEL OF EVIDENCE: Level III.

Percepción de maestras sobre el acompañamiento fonoaudiológico en un centro de desarrollo infantil en Colombia / Perception of teachers about speech therapy accompanying in a child development center in Colombia

Este trabajo estudió la percepción de maestras beneficiarias de los proyectos de práctica profesional de Fonoaudiología de la Universidad del Valle, respecto al aporte de su acción profesional en la promoción del desarrollo de los niños en el marco de la Política Pública "de Cero a Siempre". La investigación se ejecutó con métodos cualitativos de tipo interpretativo y de corte transversal, bajo el diseño de estudio de caso. La exploración permitió concluir que el acompañamiento fonoaudiológico: i) es más efectivo cuando se reconoce y valora los saberes y requerimientos de los beneficiarios, ii) enriquece los procesos de desarrollo de niños y niñas en general y no sólo a aquellos con patologías del lenguaje o discapacidad y iii) potencia el objeto de la política pública de atención a la primera infancia en Colombia. Adicionalmente, valida la acción fonoaudiológica desde una propuesta situada y bajo el enfoque comunitario

This study was focused on the perception of teachers who participated as beneficiaries on the professional practice in speech therapy implemented by the Universidad del Valle. The main focus was on how participants' professional intervention promoted the development of children, within the framework of the Public Policy "de Cero a Siempre". The practice was developed at Universidad del Valle from August 2013 to June 2016. The research was conducted using interpretative qualitative methods and was cross-sectional (case-study design). The study concluded that: i) success of the speech therapy intervention is related to the recognition and evaluation of the beneficiaries' requirements ii) the speech therapy intervention improves development processes of all children, not only of children with language pathologies or disabilities, iii) the intervention fosters the Public Policy of attention to Early Childhood in Colombia. Finally, the observed practices validate speech therapy action from a community approach.