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Paediatric oncological surgery is the branch of paediatric surgery that is dedicated to the surgical treatment of paediatric oncological and haematological diseases and their complications. It is one of the basic pillars for the treatment of solid paediatric tumours.
These are illnesses that, due to their severity, complexity, and rareness, must be centralised in hospitals that are equipped with experienced multidisciplinary teams and the technology and medical experience necessary. The evolution of this unit has often gone hand-in-hand with the surgical advances achieved in solid organ transplants, which has allowed it to develop advanced techniques that now make enormously difficult cases operable. In addition, it frequently requires collaboration from other highly complex paediatric specialities (heart surgery, neurosurgery, spinal surgery, plastic surgery, etc.).
Vall d’Hebron is the hospital that offers the most oncology services in Catalonia, and it is a member of the European Reference Networks (ERNs) for Paediatric Oncology “PaedCan” and Rare Haematological Diseases “EuroBloodNet”. It is also accredited by JACIE for paediatric haematopoietic stem cell transplants.
Paediatric tumours are complex and rare. Treating them in reference centres such as Vall d’Hebron offers the maximum chances of success. The Oncology Surgery Unit is a highly specialised reference unit that works in collaboration with the Paediatric Oncohaematology Department and other related departments, to offer the patient the best possible quality of care. We boast medical, surgical, and central departments that are highly specialised in oncological care and that ensure a comprehensive vision of the process. They incorporate all of the preventative, diagnostic, therapeutic, and monitoring aspects that these patients require, including personalised therapies and the use of genomic platforms. The hospital has some of the latest technological advances at its disposal, which allows us to offer everything from minimally invasive and robotic surgery to combined treatments using interventional radiology and complex multidisciplinary interventions. The position of Vall d’Hebron Hospital as a national reference centre for paediatric solid organ transplants allows for comprehensive care in cases where transplants are the only treatment or part of the treatment (especially in liver and kidney tumours) to cure the illness.
The Unit also provides the surgical treatments necessary for benign and malignant paediatric haematological diseases and haematopoietic stem cell transplants, such as fertility preservation techniques and the removal of the spleen in some types of anaemia.
We also participate in VHIR’s Translational Research in Cancer in Children and Teenagers Group as a fundamental part of the team, which works closely with clinical care, mostly through the Programme for Personalised Medicine in Paediatric Cancer. We also collaborate with other national and international research centres, along with several international collaborative groups for solid paediatric tumours. This allows us to remain at the forefront of surgical treatment for paediatric oncohaematology patients.
Either as a unit or individually, we participate in and/or are accredited by, via external audits, the following national and international networks, which guarantee that patients can access our unit from any point within the Spanish or European healthcare system:
ERN (European Reference Networks)
Reference Centres, Services and Units (RCSU)
The Unit treats all kinds of benign and malignant tumours, both visceral and of the soft tissue (thoracic and abdominal), with the exception of tumours of the central nervous system, the locomotor apparatus, and the heart, which are operated on by other surgical departments at our centre. We cover the age range from the prenatal period to adolescence, and even treat young adults (for some types of tumours).
We treat, among others, the following solid tumours:
Among the soft-tissue sarcomas, the following are included: retroperitoneal tumours, sarcomas of the biliary tract, gynaecological sarcomas, etc. We are a reference centre in Spain for the treatment of all kinds of paediatric sarcomas, and we are part of the EpSSG Surgical Subcommittee.
In bone sarcomas, we treat tumours of the thoracic wall, even when the vertebrae and medullary canal are affected (in collaboration with the Spine Unit) and/or the case requires complex thoracic reconstruction.
Regarding haematological diseases, we would especially like to mention:
Lastly, the Oncology Surgery Unit coordinates and takes part in Vall d’Hebron Hospital Paediatric Vascular Anomalies Committee, which meets once a month. This committee is comprised of dermatologists, plastic surgeons, paediatric surgeons, radiologists, pathologists, interventional radiologists, oncologists, and paediatricians. Its objective is to diagnose and treat the most complex cases of anomalies and both cutaneous and visceral vascular tumours.
The Paediatric Oncology and Haematology Department is a leader in treating cancer in childhood and adolescence. Of every 1,000 new cases of childhood cancer detected every year in Spain, 200 are diagnosed in Catalonia.
According to data from the Spanish Register of Tumours in Infants (RETI), ours it the Department that treats the most children in Spain, and is the leading centre for the transplant of haematopoietic progenitors or stem cells (better known as "bone marrow transplants"), having performed more than 1200 such operations. The Paediatric Oncology and Haematology Day Hospital handles up to 3,600 treatment visits a year and up to 7,600 visits for consultations.
Our experience, staff and advanced technological prowess mean our Department can offer multidisciplinary, comprehensive care to patients and their families, covering all diagnostic procedures and offering the most advanced treatments. We are a self-sufficient department when it comes to applying the latest care techniques in this field, and we also have resources to carry out research in such diseases.
Childhood cancer is the leading cause of child mortality due to illness in children more than one year old. Survival is currently around 80%, but it is essential we advance research into the disease to achieve more effective treatments.
The Department has a multiprofessional team of staff made up of doctors, nurses and others. Their functions include:
The Group for Translational Research into Childhood and Adolescent Cancer is focused on research for new treatment targets or molecule targets (the place in the organism a drug acts on), based on the most advanced knowledge available on the biology of paediatric cancers. The Group has identified and will continue to work on new molecular targets for sarcomas (cancer that originates in connective tissue cells) and tumours of the nervous system.
Collaborations with the biotechnology industry are currently being established and consolidated in order to develop new drugs capable of inhibiting pro-oncogenic processes, such as invasion and proliferation, in order to provide patients with alternative therapy options.
As an international centre of reference, our Department belongs to the International Network of Excellence in the Treatment of Cancer in Children and Adolescents. We carry out clinical work, research and teaching activity in coordination with international scientific societies: International Society of Paediatric Oncology (SIOP), European Society for Blood and Marrow Transplantation (EBMT), Center for International Blood and Marrow Transplant Research (CIBMTR), and national societies: Spanish Society of Paediatric Haematology and Oncology (SEHOP), Programme for the Study and Treatment of Malignant Haemopathy (Pethema).
Based on data from the National Registry of Child Tumours, our hospital diagnoses and treats the most children. Their survival rates are comparable to the most prestigious international centres of excellence. Our centre was the first in Spain to obtain JACIE accreditation (Joint Accreditation Committee ISCT and EBMT), the most prestigious in our field.
The Haematopoietic Progenitors Transplant Unit is the most active of its kind in Spain, with an average of 40 transplants per year. We perform all kinds of transplants, and are pioneers in complex cases, such as unrelated donors and umbilical cord blood transplants. We also perform transplants in cases of malignant oncohaematological diseases, acquired medullary aplasias and congenital pathologies such as immunodeficiencies, haemoglobinopathies, metabolopathies and medullary insufficiencies.
We should highlight our translational research group, which applies the knowledge acquired from basic research to the prevention and treatment of clinical cases in childhood cancer and haematological diseases, which contributes to better diagnosis, prognosis, treatment and control of such diseases. The Department has a Clinical Trials Unit for Innovative Treatments and belongs to the Innovative Therapy in Cancer Children (ITCC) group.
The Paediatrics Teaching Unit has extensive experience in training specialists. There are a total of 60 Paediatrics residents at Vall d’Hebron University Hospital, 15 per year. Over the last few years, Paediatrics at Vall d’Hebron has been the first choice for new residents, and in the 2017 exam session achieved the best results of any Spanish hospital. In addition to this, we receive residents from hospitals all over the world.
Pediatric training itineraries
Over the last few years, paediatrics at Vall d’Hebron has been residents’ first choice, and in the 2017 exam session achieved the best results of any Spanish hospital.
The Department has a Paediatrics Teaching Subcommittee, comprising twelve tutors and twenty residents overseeing the practical application of the training and its integration into healthcare activities. Thanks to the involvement of these professionals, we can ensure supervised completion of the training programme objectives.
This Teaching Unit comprises different healthcare departments and units, including the Paediatrics, Nephrology, Neonatology, Paediatric Oncology and Haematology, Intensive Care, Neurology, Endocrinology, Infectious Diseases, Allergies, Cardiology, Respiratory Medicine, Gastroenterology, and A&E Departments.
It is vital for residents to train in research methodology as this is necessary to take part in and develop research projects. From the second year onwards, we invite residents to carry out research work, and a minimum number of papers and publications is required in addition to their full cooperation in sessions within the Department.
Why specialise at Vall d’Hebron?
The complexity of the diagnoses and treatments performed by the Medical Oncology Department requires working in multidisciplinary teams of specialists, with the aim of providing an integrated approach from diagnosis to the end of treatment. For this same reason, we work in expert cancer-specific committees and assess each case as a team to determine the appropriate treatment for each person. If you train with us, you will be working with highly qualified professionals and the latest generation technology. Training is backed up by our own training programmes and through collaboration with centres of recognised quality and prestige.
Medical Oncology training itinerary
The core of this teaching unit is provided by the Medical Oncology Department, with participation from Haematology, Internal Medicine, Radiation Oncology, Radiology, Pathological Anatomy, Infectious Diseases and Palliative Care, the Intensive Care Unit and the A&E Department. The Unit can accommodate three residents per year. Residents’ training in Medical Oncology takes five years in total. The two first years are spent on core training, with the following three years dedicated specifically to specialisation.
Residents in medical oncology are expected to have in-depth knowledge of preventative, diagnostic and therapeutic choices for cancer. For this reason it is important that they continuously update their knowledge of cancer biology. To this end, they must take part in research projects that promote excellence in research. They will also have the opportunity to become familiar with the main lines of research in the Department and to take part in some of them. Over the course of training, residents learn to have a critical and open approach to the high volume of clinical studies and advances in the specialisation, whilst always keeping ethical considerations at the forefront of their work.
Why do your residency at Vall d’Hebron?
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