Pediatric surgery in Spain

And medical science has made an enormous amount of progress…the possibility of treating a baby in utero before birth was something only imagined until very recently.

Thousands of such operations have been performed in Barcelona, many for the very first time in the world.

The San Joan de Déu and Dexeus hospitals in Barcelona offer comprehensive care based on the application of the latest scientific achievements paired with the care and support of the child and his/her family. Parents are always by their child’s side, particularly in potentially traumatic situations. Every last detail the children’s clinics in Barcelona was designed and created for children, often with their input and participation. Here, psychologists work to prepare the child for hospitalization, there are teachers, volunteers, clowns, musicians, artists and even four-legged friends – everything is designed to make the experience as positive as possible for young patients.

PEDIATRIC CARDIAC SURGERY IN BARCELONA

Barcelona is one of the leading destinations for children from other countries seeking medical treatment. And it is no coincidence: two Barcelona hospitals in particular enjoy international recognition in pediatrics. Sant Joan de Déu University Hospital in Barcelona is rightfully considered a benchmark for European pediatrics and the Dexeus University Hospital, run by one of the most well-known infantile heart surgeons in Europe, is widely recognized for its cardiac surgery department, as is the Children’s Clinic at the Vall d’Hebrón University Hospital.

These centers provide treatment for complex cardiac diseases including congenital structural defects of the heart, cardiac rhythm and electrical conduction disorders, and congenital or acquired cardiac disease:

• ventricular septal defect (VSD)
• interatrial communication
• patent ductus arteriosus (PDA)
• coarctation of the aorta (CoA or CoAo)
• single ventricle
• transposition of the great arteries
• arrhythmia
• Tetralogy of Fallot

The cardiac department at the Sant Joan de Déu University Hospital, led by Dr. José María Caffarena, pioneer in several operations, achieved one of the best safety rates. The arrhythmia treatment is provided by world-renowned Dr. Josep Brugada (who discovered the Brugada syndrome), who performs over one hundred exclusively pediatric surgeries a year and participates as a prominent speaker at all the main medical societies in his specialty.

Barcelona can be proud of its reputation as a leading destination for cardiac surgery. Dr. Raul Abella, Head of the Pediatric Cardiac Surgery Department at the Vall D’Hebron University Hospital (public hospital) and the Dexeus University Hospital (private hospital), and his team audit and submit their outcomes according to international indicators in cardiac surgery. And these figures speak for themselves! With 400 operations a year:

• Patients under 1 year – 61%
• Aristotle Basic Complexity (ABC) Score (international scale for cardiac surgery): 8.1 points
• Survival: 98%

PEDIATRIC ORTHOPEDIC SURGERY IN BARCELONA

Spain, and specifically Barcelona, is an international leader is yet another medical specialty: orthopedic surgery. A multidisciplinary team, led by Dr. Jorge Knorr, uses the most advanced surgical methods to correct spinal deformities, and vascular microsurgery to reconstruct limbs affected by tumors, traumas, infections, etc.

Also significant are its outstanding results in the surgical treatment of congenital and acquired pathologies of the extremities in children: hip disease, reconstructive surgery for congenital deformities, severe cases of equinovarus foot or dysmetria, severe cases of arthrogryposis, brachial plexus surgery and the treatment of bone infections in children using microsurgical reconstruction techniques.

The hospital uses the most advanced transplant techniques for a full range of prostheses, from aesthetic to microelectrodes, and specializes in prosthetic grafts, that is, prostheses that allow a child to continue to grow, for severe bone defects and after operations to remove tumors. The first bionic hand was transplanted in a child for the first time in the world at Hospital Sant Joan de Déu in Barcelona.

PEDIATRIC NEUROSURGERY IN BARCELONA

The neurosurgery service in Barcelona, directed by Dr. Jordi Rumia, is recognized for its outstanding results in the surgical treatment of craniosynostosis, childhood epilepsy, hydrocephalus, plagiocephaly, and nervous system tumors at the base of the skull and spine. Its specialists have also been pioneers in the implantation of deep brain stimulation (DBS) electrodes for dystonia and motor disorders in children, as well as in the treatment of refractory epilepsy, ataxia and hereditary paraplegia in children. Hospital Sant Joan de Déu is a world leader in this area, as are Dr. Rocamora and Dr. Conesa and their teams at the Dexeus University Hospital and Dr. Russi and Dr. Oliver and their teams at Teknon.

PEDIATRIC ONCOLOGY IN BARCELONA

There has been a dramatic improvement in the cure and survival rates for childhood cancer in recent years. Children and adolescents diagnosed with this disease should only be treated by a team of doctors who specialize in pediatric oncology, have extensive experience and work with the most innovative methods with the best results.

Barcelona is home to a number of leading childhood cancer centers, including the oncology department at Hospital Sant Joan de Déu Barcelona, headed by Dr. Jaume Mora, who sees more than 200 new cases a year, and the pediatric oncology department at Hospital Dexeus, directed by the world-renowned expert Dr. Josep Sánchez de Toledo, offering treatments for a range of childhood cancers:

– Leukemia (including bone marrow transplants) at Sant Joan de Déu. The center is one of only a handful in Europe and the only one in Spain where CD19-targeted cell therapy is used in clinical trials to treat patients diagnosed with lymphoblastic leukemia.

– Neuroblastoma. Dexeus boasts outstanding outcomes that place them at the international forefront of this specialty, comparable only with those obtained by the team at the Memorial Sloan Kettering Cancer Center in New York, with the Sant Joan de Déu Children’s Hospital being the first in Europe to use Anti-GD2 immunotherapy to treat high-risk neuroblastoma, a technique that increases survival by 20%.

– Retinoblastoma. The outstanding achievements in the treatment of retinoblastoma in Barcelona has been driven by Dr. Guillermo Chantada, an international expert in the treatment of this disease, who pioneered the use of intraarterial chemotherapy to avoid eye loss in Europe. A clinical trial for intravitreal therapy using the VCN001 oncolytic virus is also being conducted for patients with refractory disease.

– Muscle and bone tumors (sarcoma) with exceptional outcomes treating Ewing’s sarcoma.

– Brain stem gliomas

– Histiocytosis

– Renal tumors

– Treatment of rare hematologic diseases: hemoglobinopathy, congenital and acquired bone marrow diseases (Fanconi’s anemia, Schwamman-Diamond syndrome, Diamond-Blackfan anemia, etc.), congenital and acquired neutropenia, acute immune thrombocytopenia and other types of thrombocytopenia, clotting factor deficiencies, hemolytic anemia, pancytopenia, eritroblastopenia, leukopenia, etc.

Both hospitals work with the most advanced therapies and diagnostic techniques designed to ensure that treatment starts as quickly as possible.

These innovations aim not only to find the most effective methods, but also the least aggressive: for example, researchers at Hospital Sant Joan de Déu have developed a tissue made of nanofibers for the local treatment of cancer, making it possible to apply chemotherapy topically instead of intravenously in some cases.

Hospital Sant Joan de Déu is one of the few European medical centers to have an exclusive tumor bank in pediatric oncology, which provides massive research potential that results in the radical improvement of disease prognosis.

PEDIATRIC NEUROREHABILITATION IN BARCELONA

The pediatric rehabilitation department at the Institut Guttmann University Institute of Neurorehabilitation carries out close to 400 intensive rehabilitation treatments for children a year with severe nervous system injuries due to brain damage after suffering a stroke or trauma, spinal cord injury or children with severe forms of cerebral palsy. In recent years, the hospital has also specialized in the placement of pediatric diaphragmatic pacemakers, a solution for patients on mechanical ventilation. In these cases, a diaphragmatic pacemaker can fully change the patient’s quality of life.

FETAL MEDICINE AND FETAL SURGERY IN BARCELONA

One in 10 fetuses suffers fetal growth problems that occur during pregnancy. Fortunately, most of these problems are mild, but some can compromise the survival of the fetus or the baby’s quality of life at birth.

As Dr. Eduard Gratacós, one of the most highly renowned experts in the world of fetal medicine, says, “weeks in fetal life amount to years for a child or decades for an adult. Therefore, finding solutions to the fetal problems that occur during development allows us to open a window of unique opportunity in terms of diagnosis and early intervention”.

One of the three most cited global specialists in fetal medicine and surgery (International Citation Index), Dr. Gratacós has 20 years of experience and has performed over 1,700 fetal surgeries, many of which were the first of their kind. To give just one example, Dr. Gratacós performed in-utero surgery on a fetus with a completely blocked larynx for the first time in history, saving the baby’s life…just another one of the “Made in Barcelona” medical miracles.