Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care

Peer-review quarterly medical journal.


Journal founders



Scientific-practical Journal "Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care" is the official organ of the Russian Association of pediatric surgeons, published since 2010. 

In the Journal "Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care" articles of scientific and practical value for a wide range of surgeons and specialists of related professions are published. The journal presents the original work of scientists from CIS countries and far abroad, materials from the international and domestic conferences. Special attention is paid to main national projects in healthcare, high-tech types of medical care in various fields of pediatric surgery, organization of surgical care to children, the development of clinical guidelines, training of specialists. The editorial Board and editorial Council of Journal "The Russian Bulletin of pediatric surgery, anesthesiology and critical care medicine" is formed of prominent scientists, heads of leading hospitals, leading specialists and well-known children's surgeons and anesthesiologists-resuscitators from all over the world.

Types of accepted articles

  • reviews
  • systematic reviews and metaanalyses
  • original research
  • clinical case reports and series
  • letters to the editor
  • short communications


  • in English and Russian
  • quarterly, 4 issues per year
  • continuously in Online First
  • with NO Article Processing Charges (APC)
  • distribution in Open Access with the CC BY-NC-ND 4.0 License.




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Current Issue

Vol 13, No 1 (2023)


Report on the work of the chief pediatric surgeon of the Ministry of Health of the Russian Federation in 2022
Morozov D.A.

This editorial presents a report on the work of the Chief Pediatric Surgeon of the Ministry of Health of Russia for 2022. From the very beginning of his activity, he established regular interaction with the chief supernumerary pediatric surgeons and executive and legislative authorities of the regions of the Russian Federation, both remotely and by visiting surgical clinics in 15 cities. To prepare a program for the creation of interregional centers for specialized surgical care in the most popular medical specialties, much attention was given to the improvement of pediatric surgical care in the Far East with repeated trips to this region. As a result of the joint work with leading specialists of the Russian Association of Pediatric Surgeons and chief pediatric surgeons of the Russian Federation, the first “Regulations on Interregional Centers for Neonatal Surgery” was created. Chief pediatric surgeons organized surgical care for children in the special military operation zone and border regions with business trips to Taganrog, Rostov-on-Don, and Lugansk. Throughout the year, he coordinated round-the-clock assistance to injured children, and dozens of telemedicine consultations were held. Based on the result of a systematic survey of the chief supernumerary pediatric surgeons of the Russian Federation, a consolidated report on the activities of the pediatric surgical service of the Russian Federation for 2021 was formed, which was important to develop prospects for its further development.

The work plans of the chief pediatric surgeon for 2023 include the completion of important documents for the specialty: “The procedure for providing surgical care to children” and the “Professional standard for a pediatric surgeon”. There was also a task of implementing interregional neonatal surgery centers in the Far Eastern Federal District, and expert, educational work, and audit of children’s surgical clinics will be continued.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2023;13(1):5-11
pages 5-11 views

Original Study Articles

Сombination of pectus carinatum and Scheuermann–Mau disease in children: An empirical pattern or somite syndrome?
Vorobyeva E.A., Razumovskiy A.Y., Dubrov V.E., Vybornov D.Y., Krestyashin I.V., Mitupov Z.B., Vakhova E.L.

BACKGROUND: In recent years, the number of children with pectus carinatum tended to increase. The literature describes only a few cases of a combination of keeled chest deformity with a more serious pathology of the spine, i.e., Scheuermann–Mau disease.

AIM: This study aimed to examine the frequency, clinical manifestations, and timely diagnosis of combined structural lesions of the thoracic spine in children with keeled chest deformity.

MATERIALS AND METHODS: This observational single-center cross-sectional study included patients aged 5–17 years with pectus carinatum. Categorical values were described by indicating absolute values and percentages in the sample, and quantitative indicators with normal distribution were described using arithmetic means and standard deviations and 95% confidence intervals. Quantitative indicators without normal distribution were described using the median and interquartile range.

RESULTS: Scheuermann–Mau disease was detected in 11 (9.3%) of 118 children with pectus carinatum. “Pterygoid scapulae” was noted in 97 (82.2%) children with pectus carinatum, increased cervical lordosis in 93 (79.7%), and sloping, anteriorly adducted shoulders in 99 (83.9%), which significantly hampered the clinical assessment of the extent of thoracic kyphosis. At the time of examination, a rigid thoracic kyphosis was formed in a 16-year-old boy. In younger children (5–14 years old), Scheuermann–Mau disease had no clinical manifestations and was detected only during screening X-ray examination, whereas in the older age group (15–16 years), 3 of 4 adolescents complained of back pain.

CONCLUSIONS: The frequency of Scheuermann–Mau disease in children with pectus carinatum exceeds the average prevalence in the population. In patients with keeled chest pterygoid scapulae, excess cervical lordosis, and rounded shoulders are associated with the difficulty of the assessment of the magnitude of thoracic kyphosis. Asymptomatic progression of Scheuermann–Mau disease is typical in younger children with pectus carinatum, and pain syndrome and the clinical picture of the disease develop only by the age of 15–16 years. Thus, all patients with pectus carinatum and posture disturbance should undergo a screening X-ray examination of the thoracic and lumbar spine to detect Scheuermann–Mau disease and initiate treatment in time.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2023;13(1):13-24
pages 13-24 views
Predictors of the need for re-evacuation of newborns from secondary level hospitals
Mukhametshin R.F., Kovtun O.P., Davydova N.S.

BACKGROUND: The medical evacuation of premature newborns to institutions providing a higher level of medical care results in the reduction of death risk. The use of pediatric intensive care units in level 2 organizations for the hospitalization of newborns can be a potential solution to the lack of neonatal beds in level 3 institutions.

AIM: This study aimed to determine the predictors of the re-evacuation of newborns from level 2 medical organizations to level 3 institutions.

MATERIALS AND METHODS: This observational, cohort, retrospective study included data of 284 cases of the evacuation of newborns from level 1 and 2 medical organizations without a pediatric intensive care unit to level 2 medical organizations with a pediatric intensive care unit. The sample was divided into two groups: the first group included patients who received the necessary therapy in level 2 medical organizations and did not require further evacuation to level 3 (n = 261), and the second group included patients who required further transfer to level 3 (n = 23). Anamnesis data, nosological structure, respiratory support parameters, intensive therapy, and volume of pretransoport activities in the groups were analyzed. Methods of statistical analysis included median, interquartile range, proportion and its 95% CI, Fisher exact test, Mann–Whitney test, receiver operating characteristic analysis, and odds ratio.

RESULTS: The predictor of the requirement for re-evacuation was birthweight (area under the curve [AUC] 0.658 [0.522–0.795]). When only patients on a ventilator were included in the analysis, the saturation oxygenation index (AUC 0.730 [0.579–0.863]) and the SpO2/FiO2 ratio (AUC 0.720 [0.571–0.869]) have the maximum predictive value.

CONCLUSIONS: Birthweight of <1390 g (AUC 0.658 [0.522–0.795], sensitivity 0.348 [0.153–0.542], and specificity 0.950 [0.924–0.977]) is a predictor of the requirement for further evacuation of newborns from level 2 pediatric and neonatal intensive care units to a level 3 organization. For patients on a ventilator, such predictors included saturation oxygenation index > 4.25 (AUC 0.730 [0.579–0.863], sensitivity 0.471 [0.233–0.708] and specificity 0.928 [0.888–0.967]) and SpO2/FiO2 ratio < 265.71 (AUC 0.720 [0.571–0.869], sensitivity 0.588 [0.354–0.822], and specificity 0.837 [0.781–0.893]). However, the high negative and low positive predictive values for these parameters do not allow their solitary use when deciding about routing a newborn.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2023;13(1):25-36
pages 25-36 views


Vascular bypass surgery in the treatment of extrahepatic portal hypertension in children (review)
Mitupov Z.B., Razumovsky A.Y., Rachkov V.E., Kulikova N.V., Margaryan S.R.

In children with extrahepatic portal hypertension (EPHT), the most frequent and life-threatening complication is bleeding from varicose veins of the esophagus and stomach. Therefore, the main task of HSV treatment is to prevent bleeding from the veins of the upper gastrointestinal tract. The most effective treatment is portosystemic bypass surgery, with effectiveness of 94%–97%. However, the use of these operations is limited precisely by a decrease in portal liver perfusion and development of portosystemic encephalopathy. This study aimed to analyze domestic and foreign publications devoted to the surgical treatment of portal hypertension and the development of portosystemic encephalopathy during the postoperative period. A systematic search was carried out in PubMed, Web of Science, Scopus, MEDLINE, eLibrary, RSCI, and Cyberleninka; 345 references were analyzed, 110 articles were reviewed, and 97 publications on the surgical treatment of portal hypertension were selected for the review. The development of portosystemic encephalopathy during the postoperative period often occurs after the imposition of total portosystemic bypass surgery. To reduce the risk of developing portosystemic encephalopathy, selective shunts have been developed, which to some extent preserve the PPP. With distal splenorenal anastomosis, the frequency of portosystemic encephalopathy is 10%–15%. An intermediate position is occupied by a side-to-side splenorenal anastomosis, which has signs of selective surgery. The results of the analysis of literature sources showed that discussions are still underway regarding the choice of the optimal treatment strategy for patients with EPHT, place and role of endoscopic methods for the prevention of gastrointestinal bleeding, and mesoportal shunt in the treatment of patients with EPHT. Nevertheless, the majority of world experts consider mesoportal shunt to be the most optimal operation for the primary and secondary prevention of varicose bleeding and other HSV complications. If it is impossible to perform, selective bypass surgery of the distal splenorenal anastomosis can be an alternative to a mesoportal shunt.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2023;13(1):37-52
pages 37-52 views

Case reports

Robot-assisted bladder diverticulectomy in a 9-year-old boy
Mosoyan M.S., Fedorov D.A., Osipov I.B., Burkhanov V.V., Pervunina T.M., Kagantsov I.M.

Pediatric urologists rarely encounter bladder diverticulum in children. If the bladder diverticulum has clinical manifestations such as pain, urinary tract infection, hematuria, voiding dysfunction, vesicoureteral reflux, or obstruction of the ureterovesical anastomosis, then surgical treatment is indicated. Recently, numerous publications began to appear on the removal of the bladder diverticulum using laparoscopic or vesicoscopic access. Several foreign publications have reported on the removal of a bladder diverticulum in children using a robotic approach. A 9-year-old boy who was diagnosed with a bladder diverticulum underwent robot-assisted bladder diverticulectomy in January 2020 at the Almazov National Medical Research Centre. Ports of da Vinci 12 and two 8-mm ports, as well as an assistant 5-mm port, were used, which were installed in typical places for lower abdominal surgery. The duration of the operation was 135 min, and the console time was 75 min. The blood loss volume was 20 mL. The patient was in the intensive care unit for 1 day. The urethral catheter was removed on day 7 after the operation. Urination independence, delays, and incontinence were not noted. The patient was discharged on postoperative day 9 in satisfactory condition. At the control examination after a year at the patient’s residence, she had no complaints, urination was not disrupted, and there were no pathological changes in the ultrasound of the kidneys and bladder. Robot-assisted bladder diverticulectomy in children is a feasible, effective, and safe treatment option in expert centers with extensive experience in robotic surgery. The described clinical case of bladder diverticulectomy is the first in Russia, which was performed using a robotic system in pediatric practice.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2023;13(1):53-61
pages 53-61 views
Use of indocyanine green in the resection of renal cysts in children
Kozlov Y.A., Poloyan S.S., Marchuk A.A., Rozhanski A.P., Byrgazov A.A., Kovalkov K.A., Kapuller V.M., Narkevich A.N., Muravev S.A.

Fluorescent imaging technology with indocyanine green (ICG) is used to improve intraoperative visualization of the anatomical structures of the affected organs and increase the efficiency of laparoscopic or robotic operations. Recently, ICG imaging has been used in pediatric gastroenterology, oncology, and urology.

In this study, we present laparoscopic treatment of two cases of simple renal cysts in two male patients aged 10 and 12 years. Resection of the extrarenal portion of the kidney cyst was performed using fluoroscopic control by intravenous administration of ICG. The intrarenal residue was subjected to argon-plasma coagulation. Treatment outcomes were assessed over a follow-up period of 6 and 12 months. The cyst sizes measured before surgery using ultrasound and computed tomography were 50 and 70 mm. Both cysts were located in the lower pole of the right kidney. The operation times were 40 and 45 min. During the surgical intervention, no complications such as bleeding from the kidney parenchyma or damage to neighboring organs occurred. In all cases, the cyst contained a clear liquid without pathological impurities. The cytological examination revealed a low cell content, which was represented by single macrophages and urothelial cells. Histological analysis revealed that the lining of the cyst wall was represented by the transitional epithelium without signs of malignancies. The hospital length of stay was 3 days. Ultrasound examinations performed 1, 3, 6, and 12 months after the operation did not detect signs of disease recurrence. Thus, based on the presented clinical case, the main advantage of using fluorescent technology during kidney cyst resection include a clear definition of the demarcation line between the avascular wall of the cyst and the perfused kidney tissue, which helps prevent bleeding from the renal parenchyma.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2023;13(1):63-72
pages 63-72 views
Diagnostics and surgical management of periampullary duodenal duplication cysts in children: a report of cases
Sokolov Y.Y., Tumanyan G.T., Efremenkov A.M., Omarova Z.R., Koshurnikov O.Y., Gogichaeva A.A.

BACKGROUND: Obstructive variants of chronic duodenal obstruction may be caused by congenital malformations, such as rare periampullary duodenal duplication cysts. This localization of gastrointestinal duplications is the rarest and is not described in the domestic literature.

AIM: This study aimed to present the experience of the management of periampullary duodenal duplication cysts in children.

CASES REPORT: Seven children with periampullary duodenal duplication cysts underwent surgery between 2007 and 2022. All patients suffered from prolonged abdominal pain, vomiting of food, and bile. Two children had recurrent pancreatitis, and one child underwent repeated operations for high intestinal obstruction and biliary obstruction in other hospitals. An abdominal cyst was suspected in one patient at another hospital, and the child underwent exploratory laparoscopy, but no formation was found. Ultrasound, gastroduodenoscopy, computed tomography, and magnetic resonance imaging were performed on these children. Ultrasound examination showed a peristaltic cystic formation up to 4 cm in diameter with a double wall. Gastroduodenoscopy showed formation in the second portion of the duodenum in the region of the major duodenal papilla. This formation covers the intestinal lumen by two-thirds and up to nearly complete obturation. The relationship between duodenal duplication and the bile and pancreatic ducts was clarified on magnetic resonance cholangiopancreatography: the relationship was suspected in two children. All patients underwent wide transduodenal excision of periampullary duodenal duplication cyst; in four cases, laparoscopic access was used. No intra- and postoperative complications occurred. Histological examination revealed true duplications in all cases. The children were discharged on days 11–12. In the follow-up after 3 months and 10 years, no complications were noted.

CONCLUSIONS: Periampullary duodenal duplication cysts can be a cause of chronic duodenal obstruction. Transduodenal excision of periampullary duodenal duplication cysts is the optimal treatment, and this operation can be performed laparoscopically.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2023;13(1):73-82
pages 73-82 views
Endoscopic ultrasound-guided cystogastrostomy in the treatment of the complicated form of acute pancreatitis in children
Pavlushin P.M., Gramzin A.V., Drobyazgin E.A., Dobrov S.D., Okhotina A.A., Nikulina A.B., Arkhipov D.A., Krivosheenko N.V., Koynov Y.Y., Tsyganok V.N., Chikinev Y.V.

Acute pancreatitis is relatively rare in children, with approximately 3–13 cases per 100,000 populations annually, and complicated forms are three times less common than those in adults. However, recently, the number of acute pancreatitis cases in children has increased, which entails a relatively higher incidence of complicated acute pancreatitis, including parapancreatic acute fluid accumulation, and determines the relevance of this problem for pediatric surgeons.

In this study, using two sample observations, parapancreatic pseudocyst puncture under ultrasound and X-ray control was presented, a conductor string was introduced into the cavity of the pseudocyst, and further stenting of this anastomosis was performed with two plastic double-pigtail stents. In the first case, a 12-year-old boy underwent surgery for idiopathic pancreatitis and acute parapancreatic fluid accumulation in the pancreatic tail. In the second case, a 10-year-old girl presented with a parapancreatic pseudocyst, which was caused by drug-induced pancreatitis (a complication of the long-term use of valproic acid, an antiepileptic drug). Both children underwent surgery using this technique. Antisecretory therapy was performed postoperatively. In the catamnesis after 1 year and 6 months, the children had no complaints, and ultrasound and X-ray studies did not reveal any pathology. Endoscopic cystogastrostomy under ultrasound guidance is widely performed in complicated pancreatitis in adults. These observations show its effectiveness in pediatric practice. However, the relatively short observation period of treatment results requires additional research on a much larger number of cases and outcomes of these surgical interventions in children.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2023;13(1):83-93
pages 83-93 views
Cross-fused dystopia of the right kidney with cystic dysplasia of the non-functioning left kidney associated with an ureterocele
Kuzovleva G.I., Rogozhina V.V., Staroverov O.V., Ayryan E.K., Khvatynets N.А., Rostovskaya V.V.

Cross-dystopia is a rare type of congenital anomaly and is characterized by a displacement of the kidney to the opposite side; as a result, they are both located on the same side, and in approximately 85% of such cases, a fusion of the parenchyma of two kidneys can be observed. We have not found reports of cases in which a nonfunctioning orthotopic cystic dysplastic kidney associated with ureterovesical segment pathology (ureterocele) was fused with the lower pole of a cross-dystopian normally formed kidney in the literature. The patient, 8 days old, had a preliminary diagnosis of agenesis of the right kidney, doubling of the left kidney, cystic dysplasia, doubled left kidney with an ureterohydronephrosis in the lower half and ureterocele. To restore the urine outflow and function of the lower half of the presumably doubled left kidney, a cystourethroscopy was performed. In a typical place on the right, there was a correctly formed ureteral orifice, i.e., an ureterocele on the left, which occupies half of the bladder volume. With a holmium laser, an artificial orifice was formed in the ureterocele to restore the urine passage. At 9 months old, tomography urinary tract was performed, which revealed cross-dystopia of the right kidney with a fusion of the lower pole and a cystic dysplastic orthotopic left kidney. Laparoscopic nephroureterectomy of a non-functioning orthotopic kidney was performed.

The control examination indicated complete clinical remission and social adaptation of the patient after discharge. Cross-dystopia of the kidney with fusion, cystic dysplastic kidney, and a ureterocele are rare congenital anomalies that require timely examination in a specialized clinic and drawing up an individual treatment plan. The surgical method should focus on a symptomatic urological problem, emphasizing preserving kidney function.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2023;13(1):95-104
pages 95-104 views
Primary intestinal anastomosis in a child with perforation of Meckel’s diverticulum and peritonitis
Morozov K.D., Sharkov S.M., Kozlov M.Y., Mordvin P.A., Ayrapetyan M.I., Morozov D.A.

This paper presents the treatment course of a 13-year-old child with Meckel’s gangrenous-perforative diverticulitis complicated by diffuse peritonitis. The perforation was localized at the base of Meckel’s diverticulum; therefore, ileal resection was performed. Peritonitis required a difficult choice of further surgical management, i.e., stoma formation or primary intestinal anastomosis. Nowadays, an enterostomy is considered the most reliable and rational surgical option after bowel resection in peritonitis conditions. However, this issue has become increasingly controversial. Many studies have confirmed the success of primary intestinal anastomosis, regardless of the severity of peritonitis and degree of contamination of the abdominal cavity, even noting the advantages of radical treatment and prevention of various stoma-related complications. In the presented clinical case, the child underwent primary intestinal anastomosis despite the exudative inflammatory process in the abdominal cavity. This option was chosen because of the stable general condition of the child, satisfactory central and peripheral hemodynamics, and absence of significant hydrobalance disorders. No complications occurred during the postoperative period. The child was discharged on postoperative day 7. In this study, we aimed to evaluate our experience with the primary anastomosis approach in peritonitis.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2023;13(1):105-112
pages 105-112 views


Commentary on the article “Primary intestinal anastomosis in a child with perforation of Meckel's diverticulum and peritonitis”
Tsap N.A.

Commentary on the article Morozov KD, Sharkov SM, Kozlov MYu, Mordvin PA, Ayrapetyan MI, Morozov DA “Primary intestinal anastomosis in a child with perforation of Meckel’s diverticulum and peritonitis” published in the Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2023;13(1):105–112. (In Russ.) DOI:

After reading the article under discussion, serious doubts were raised about the presence of diffuse peritonitis (there was no typical response of the body to a severe inflammatory process in the abdominal cavity), and the mild course of diffuse peritonitis in surgical practice is unknown. Primary intestinal anastomosis in peritonitis cannot be recommended for pediatric surgeons to present its wide introduction in clinical practice.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2023;13(1):113-117
pages 113-117 views
Commentary on the article “Primary intestinal anastomosis in a child with perforation of Meckel's diverticulum and peritonitis”
Minaev S.V.

Commentary on the article Morozov KD, Sharkov SM, Kozlov MYu, Mordvin PA, Ayrapetyan MI, Morozov DA “Primary intestinal anastomosis in a child with perforation of Meckel’s diverticulum and peritonitis” published in the Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2023;13(1):105–112. (In Russ.) DOI:

Performing a primary anastomosis in a child with Meckel’s gangrenous-perforative diverticulitis in the presence of peritonitis may be the operation of choice only in the early stages of the development of peritonitis.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2023;13(1):119-123
pages 119-123 views


In memory of Alina P. Shapkina-Pilipenko (24.01.1929 – 01.03.2023)
Gorbachev O.S.

Information about the life path of the founder of pediatric surgery in the Far East, Professor Alina P. Shapkina-Pilipenko, who died in March 2023.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2023;13(1):125-127
pages 125-127 views

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