Russian Journal of Pediatric Surgery, Anesthesia and Intensive CareRussian Journal of Pediatric Surgery, Anesthesia and Intensive CareРоссийский вестник детской хирургии, анестезиологии и реаниматологии2219-40612587-6554Eco-Vector50910.30946/2219-4061-2019-9-1-47-56Original Study ArticlesОригинальные исследованияSURGICAL TREATMENT OF NEONATES WITH GASTRIC PERFORATIONХИРУРГИЧЕСКОЕ ЛЕЧЕНИЕ НОВОРОЖДЕННЫХ С ПЕРФОРАЦИЕЙ ЖЕЛУДКАKozlovYu. A.КозловЮ. А.
Russian Federation

Head of department of neonatal surgery at Irkutsk Municipal Pediatric Clinical Hospital; professor of the department of pediatric surgery at Irkutsk State Medical University Russia; professor of the department of pediatric surgery at Irkutsk State Medical Academy of Continuing Education

Заведующий отделением хирургии новорожденных ОГАУЗ ИМДКБ г. Иркутска, профессор кафедры детской хирургии ГБОУ ВПО ИГМУ, профессор кафедры ГБОУ ВПО ИГМАПО

yuriherz@hotmail.comRasputinA. A.РаспутинА. А.
Russian Federation

Surgeon of department of neonatal surgery at Irkutsk Municipal Pediatric Clinical Hospital

Врач-хирург отделения хирургии новорожденных ОГАУЗ ИМДКБ г. Иркутска

arasputin@mail.ruBaradievaP. J.БарадиеваП. Ж.
Russian Federation

Pedaitric surgeon at Irkutsk Municipal Pediatric Clinical Hospital

Врач-детский хирург отделения хирургии новорожденных ОГАУЗ ИМДКБ г. Иркутска

p.baradieva@cloud.comOchirovCh. B.ОчировЧ. Б.
Russian Federation

Surgeon of department of neonatal surgery at Irkutsk Municipal Pediatric Clinical Hospital

Врач-хирург отделения хирургии новорожденных ОГАУЗ ИМДКБ г. Иркутска

Cimitbator@gmail.comRasputinaN. V.РаспутинаН. В.
Russian Federation

Neonatologist at Irkutsk Municipal Pediatric Clinical Hospital

Врач-неонатолог отделения хирургии новорожденных ОГАУЗ ИМДКБ г. Иркутска

Nmalenkina@ya.ruUsG. P.УсГ. П.
Russian Federation

Neonatologist at Irkutsk Municipal Pediatric Clinical Hospital

Врач-неонатолог отделения хирургии новорожденных ОГАУЗ ИМДКБ г. Иркутска

us.galina@mail.ruKuznetsovaN. N.КузнецоваН. Н.
Russian Federation

Neonatologist at Irkutsk Municipal Pediatric Clinical Hospital

Врач-неонатолог отделения хирургии новорожденных ОГАУЗ ИМДКБ г. Иркутска

KononenkoM. I.КононенкоМ. И.
Russian Federation

Neonatologist at Irkutsk Municipal Pediatric Clinical Hospital

Врач-неонатолог отделения хирургии новорожденных ОГАУЗ ИМДКБ г. Иркутска

29marinared74@mail.ruIrkutsk Municipal Pediatric Clinical HospitalГородская Ивано-Матренинская детская клиническая больницаIrkutsk State Medical Academy of Continuing EducationИркутская государственная медицинская академия последипломного образованияIrkutsk State Medical University RussiaИркутский государственный медицинский университет100520199147560805201908052019Copyright ©; 2019, Kozlov Y.A., Rasputin A.A., Baradieva P.J., Ochirov C.B., Rasputina N.V., Us G.P., Kuznetsova N.N., Kononenko M.I.Copyright ©; 2019, Козлов Ю.А., Распутин А.А., Барадиева П.Ж., Очиров Ч.Б., Распутина Н.В., Ус Г.П., Кузнецова Н.Н., Кононенко М.И.2019Kozlov Y.A., Rasputin A.A., Baradieva P.J., Ochirov C.B., Rasputina N.V., Us G.P., Kuznetsova N.N., Kononenko M.I.Козлов Ю.А., Распутин А.А., Барадиева П.Ж., Очиров Ч.Б., Распутина Н.В., Ус Г.П., Кузнецова Н.Н., Кононенко М.И.https://creativecommons.org/licenses/by-nc-nd/4.0https://rps-journal.ru/jour/article/view/509

Introduction. Gastric perforation in neonates is a rare disease with high post-operative lethality. The purpose of our study was to analyze risk factors of gastric peroration in neonates and present the surgical treatment outcomes. Materials and methods. We examined the outcomes of surgical treatment of 18 neonates with gastric perforation. At the time of surgery, they have been staying at Ivan and Matryona Children’s Clinical Hospital since January 2000. Demographic measures such as gestational age, after-birth age, gender, and weight at birth are discussed. Risk factors for gastric perforation, gastric lesion localization and disease-related lethality were estimated. Results. We observed 18 premature children with gastric perforation amounting to 13.6% of the total number of children with gastrointestinal perforations. The patients were 1 to 30 days old (mean age of 6.3 days). Mean gestational age was 34 weeks. The weight ranged from 950 to 2.600 g (mean body mass was 2,151.8 g). 10 (55.5%) children had a gastric defect on the greater curvature, 2 (11.1%) children had it on the lesser curvature and 6 (33.3%) patients had the defect on the posterior wall of the stomach. In newborns with gastric perforation, post-operative lethality was 33.3% (n = 6). Conclusion. Preliminary abdominal paracentesis and drainage of the abdominal cavity with multiple organ failure correction until the basic surgery stage will probably improve treatment outcomes and decrease lethality due to decreased pressure in the abdominal cavity.

Введение. Перфорация желудка у новорожденных – редкое заболевание с высокой послеоперационной летальностью. Цель нашего исследования проанализировать факторы риска перфорации желудка у новорожденных и представить результаты хирургического лечения. Материалы и методы. Изучены итоги хирургического лечения 18 новорожденных с перфорацией желудка, которые находились на момент операции в ИваноМатренинской детской клинической больнице с января 2000 года. В работе обсуждены демографические показатели пациентов – гестационный возраст, возраст после рождения, пол, вес при рождении. Оценивались факторы риска перфорации желудка, локализация поражения желудка и летальность, связанная с этим заболеванием. Результаты. Мы наблюдали 18 недоношенных младенцев с перфорацией желудка, что составило 13,6% от общего количества детей с перфорациями ЖКТ. Возраст пациентов составлял от 1 до 30 суток (средний возраст 6,3 суток). Средний гестационный возраст больных – 34 недели. Вес младенцев находился в интервале от 950 до 2600 грамм (средняя масса тела 2151,8 грамм). Дефект желудка располагался чаще в области большой кривизны – у 10 детей (55,5%), в проекции малой кривизны желудка – у 2 детей (11,1%) и на задней стенке желудка – у 6 пациентов (33,3%). Послеоперационная летальность у новорожденных с перфорацией желудка составила 33,3% (n = 6). Заключение. Предварительный лапароцентез и дренирование брюшной полости с коррекцией полиорганной недостаточности до выполнения основного этапа операции, очевидно, будут способствовать улучшению результатов лечения и снижению летальности в результате снижения давления в брюшной полости.

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