Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care | Peer-review quarterly medical journal
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Retrograde intrarenal surgery using a flexible ureterorenoscope in children with urolithiasis
BACKGROUND: Extracorporeal shock wave lithotripsy remains the first-line therapy in children with renal stones up to 2 cm. Recently, retrograde intrarenal surgery has become an alternative technology for fragmenting stones located in the renal pelvis and calyces. AIM: The work aimed to perform a retrospective analysis of the outcomes and complications of flexible ureterorenoscopy in children with urolithiasis. METHODS: The study included 63 children (65 renal units) who underwent retrograde intrarenal surgery. A total of 70 procedures were performed, including nephrolithotripsy in 59 cases (84.3%) and flexible ureterolithotripsy in 4 cases (5.7%). Nephrolithoextraction and ureterolithoextraction with a flexible endoscope were also performed. Stone size, volume, and density were assessed. The statistical association between the stone-free rate after retrograde intrarenal surgery and other parameters was analyzed using the Mann–Whitney test, Spearman correlation, and logistic regression. RESULTS: The median age of the patients was 11.8 years. Computed tomography revealed a median stone size of 13.2 mm and density of 1481 HU. After primary retrograde intrarenal surgery, complete stone clearance was achieved in 49 children (77.81%); after repeat intervention for residual fragments, the overall stone-free rate reached 93.66% (59 patients). Only 2 patients (3.17%) developed ureteral colic due to residual ureteral fragments after stent removal, requiring urgent intervention. Statistically significant predictors of residual fragments included initial stone size >1.6 cm on computed tomography and simultaneous stone location in both the pelvis and calyx (p < 0.05). No association was found between stone-free rate and patient age. CONCLUSION: The method of retrograde intrarenal surgery in children demonstrated a high stone-free rate and a low incidence of significant complications.
Copyright (c) 2025 Eco-Vector https://creativecommons.org/licenses/by-nc-nd/4.0
Complications of cholelithiasis in children as indications for emergency surgery
BACKGROUND: Cholelithiasis in children is a relatively rare disease; however, its incidence is increasing. Consequently, the absolute number of complicated forms may also rise. AIM: The work aimed to analyze the clinical course and outcomes of treatment of uncomplicated and complicated forms of cholelithiasis in children. METHODS: This retrospective study included 53 children treated between 2019 and 2024. Patients were divided into two groups: group 1 comprised 40 children (75.5%) who underwent laparoscopic cholecystectomy for uncomplicated cholelithiasis; group 2 comprised 13 children (24.5%) with complicated cholelithiasis, who, in addition to standard laparoscopic cholecystectomy, underwent various types of common bile duct exploration. RESULTS: The distribution of complications in group 2 was as follows: 4 (30.8%) cases of acute cholecystitis, 2 (15.4%) of acute pancreatitis, 6 (46.1%) of choledocholithiasis, and 1 (7.7%) case of spontaneous perforation of the common bile duct. Types of emergency cholecystectomy in group 2 included: 6 (46.1%) laparoscopic cholecystectomies; 4 (30.8%) cases of laparotomy with cholecystectomy, choledochotomy, choledocholithoextraction, and drainage of the common bile duct through the cystic duct stump; 1 (7.7%) laparotomy with cholecystectomy, choledochotomy, choledocholithoextraction, papillosphincterotomy, and drainage of the common bile duct through the cystic duct stump; and 2 (15.4%) endoscopic retrograde cholangiopancreatographies with papillosphincterotomy followed by delayed laparoscopic cholecystectomy. The median operative time was significantly shorter in group 1 than in group 2: 67.5 [55.0; 85.0] minutes versus 150.0 [85.0; 190.0] minutes, respectively (р=1,0×10–7). The total length of hospital stay after surgery was also significantly shorter in group 1 than in group 2 (p=1,0×10–8). Median values were 3.0 [2.0; 4.0] days in group 1 and 14.0 [12.0; 16.0] days in group 2. CONCLUSION: Diagnosis and treatment of complicated cholelithiasis in children are challenging. Its rarity makes the development of optimal therapeutic approaches particularly demanding. Endoscopic retrograde cholangiopancreatography with papillosphincterotomy is a safe and effective treatment option, though further clinical experience is needed to support its widespread use.
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Criteria for surgical treatment of left-sided varicocele in children
BACKGROUND: Determining clear indications for surgical correction of varicocele in pediatric patients remains a relevant clinical problem. AIM: The work aimed to identify parameters serving as indications for surgical treatment of varicocele in children. METHODS: A prospective study was conducted on 86 patients diagnosed with left-sided varicocele. The observation period was from September 2024 to April 2025. Patients were divided into two groups: group 1 included 54 (62.8%) surgically treated children; group 2 comprised 32 (37.2%) adolescents under outpatient follow-up. The study was conducted at the Irkutsk City Ivano-Matreninskaya Children’s Clinical Hospital. RESULTS: The median age of children in both groups was 15 [14; 16] years. The median body mass index was 19.4 [17.6; 21.5] kg/m2; underweight was identified in 30 (34.9%) adolescents. The cause of varicocele was aorto-mesenteric compression of the left renal vein in 65.1% of cases. Complaints of pain or discomfort in the left hemiscrotum were reported by 20 (23.3%) adolescents. Left testicular hypotrophy was found in 22 (40.7%) children undergoing surgery and in 4 (12.5%) patients under follow-up (p = 0.03). Differences between groups were observed in the diameter of pampiniform plexus veins (p = 0.00001). Reflux in the pampiniform plexus veins during stress tests was detected in 30 (55.5%) patients in group 1 and in 6 (18.7%) patients in group 2 (p = 0.0046). Increased flow velocity >30 cm/s occurred in 44.4% of surgically treated cases and 18.7% of those under follow-up (p = 0.048). Logistic regression analysis identified five combined factors defining precise indications for surgical correction of varicocele in children: scrotal pain or discomfort complaints (β = 0.251 ± 0.087; t(77) = 2.87; p = 0.00532); resistance index of the left testicular artery <0.5 or >0.6 (β = –0.368 ± 0.078; t(77) = –4.72; p = 0.00001); left testicular volume ≥20% smaller than the right (β = 0.276 ± 0.091; t(77) = 3.02; p = 0.00345); pampiniform plexus vein diameter >3.9 mm under stress tests (β = 0.192 ± 0.058; t(77) = 3.26; p = 0.00167); compression of the left renal vein at the aorto-mesenteric junction >8 points (β = –0.502 ± 0.141; t(77) = –3.55; p = 0.00066). CONCLUSION: Decision-making regarding surgical treatment of varicocele requires a comprehensive and personalized approach to the examination of the child. The study results provide precise criteria for surgical correction of scrotal varicose veins in adolescents, including physical examination, patient complaints, and mandatory ultrasound with testicular vessel Doppler imaging.
Selection of infusion therapy regimen in the postoperative period in children with congenital heart defects
BACKGROUND: The choice of infusion therapy regimen in neonates and infants after cardiac surgery remains a relevant challenge. The use of balanced crystalloid solutions in combination with an optimized infusion regimen may improve metabolic and hemodynamic parameters as well as myocardial contractility. AIM: This work aimed to evaluate the effectiveness of an optimized restrictive infusion regimen with balanced crystalloid solutions in neonates and infants during the early postoperative period after cardiac surgery for congenital heart defects. METHODS: This prospective cohort study included 61 children with transposition of the great arteries and total anomalous pulmonary venous return, who underwent radical cardiac surgery. Patients were allocated into groups according to the type of solution and infusion protocol used: the control group received 0.9% sodium chloride solution using a standard regimen, whereas the main group received Ringer’s balanced solution according to the optimized method (1 ml/[kg × h] + 1 ml/[kg × h] for inotropic support). RESULTS: Patients treated with the balanced solution under the optimized regimen demonstrated more pronounced improvements in pH and base deficit, stable potassium, sodium, and chloride levels, less pronounced tachycardia, and normalization of central venous pressure. Echocardiographic parameters at 24 hours indicated improved end-diastolic volume, end-diastolic index, and ejection fraction. Extubation time was reduced by 20.2%, and length of stay in intensive care units was reduced by 14.3%. CONCLUSION: The combination of balanced crystalloids with a restrictive infusion regimen in neonates and infants after correction of congenital heart defects promotes a more physiological restoration of homeostasis, reduces the need for inotropic support, and improves cardiohemodynamic parameters in the early postoperative period.
A new osteotomy technique for the treatment of children with bladder exstrophy: a case series
BACKGROUND: Bladder exstrophy is a rare congenital urological anomaly affecting the bladder, genitalia, pelvic floor, and pelvic bones. Skeletal abnormalities associated with bladder exstrophy include external rotation of the iliac bones, shortening and hypoplasia of the pubic rami, and retroversion of the acetabulum. The main challenge in defect closure is pubic diastasis. AIM: The work aimed to present a novel pelvic osteotomy technique for the treatment of bladder exstrophy. METHODS: The study included 30 patients with classical bladder exstrophy who underwent pelvic osteotomy using the proposed technique. The cohort comprised 24 boys and 6 girls, aged from 1 day to 17 years, operated in various clinics in St. Petersburg (Russia), Tashkent (Uzbekistan), and Minsk (Belarus). RESULTS: After 30 surgical procedures for classical bladder exstrophy with pelvic osteotomy performed according to our technique in children aged from 1 day to 17 years, a complication occurred in only one case—postoperative wound infection—which was treated conservatively using broad-spectrum systemic antibiotics and local therapy. This complication occurred in the group of patients who underwent reoperation after prior surgical bladder repair without pelvic osteotomy. No patient developed an increase in pubic diastasis in the postoperative period. CONCLUSION: The proposed pelvic osteotomy technique is effective for abdominal wall closure and bladder reconstruction. This is confirmed by the low complication rate (3.3%), involving both orthopedic and urological aspects, as well as the absence of postoperative pubic diastasis in all patients. Moreover, this pelvic osteotomy technique is an effective procedure due to its excellent correction of the disrupted pelvic ring and preservation of this correction.
Long-term outcomes and rehabilitation perspectives in children after neonatal sepsis: a systematic review
Neonatal sepsis remains a significant cause of mortality and long-term complications in newborns. However, evidence-based approaches to the rehabilitation of children surviving sepsis remain insufficiently developed, highlighting the need to synthesize available data. This review summarizes current evidence on the long-term outcomes and rehabilitation opportunities in children who experienced sepsis during the neonatal period. A scientific data search covering 2019–2024 was conducted in PubMed and eLibrary.ru databases using keywords related to rehabilitation, sepsis, and neonates. After removing duplicates and applying multi-stage screening for relevance to the review topic, 55 publications were included for analysis. The review revealed a high risk of long-term multi-organ sequelae after neonatal sepsis, including neurological impairments (cognitive deficits, cerebral palsy), sensory deficits, bronchopulmonary dysplasia, and cardiovascular dysfunction. It also highlights the lack of unified criteria and methodology for diagnosing neonatal sepsis, as well as protocols for assessing immediate and long-term outcomes in newborns who survived sepsis, and convincing evidence regarding the effectiveness of specific rehabilitation methods. The challenge of implementing modern rehabilitation in neonates is emphasized, since most existing scientific and practical approaches are based on extrapolation of data obtained from the rehabilitation of preterm infants or patients with other conditions, and are not supported by high-quality randomized controlled trials specifically in the population of children after sepsis. The review outlines the current three-stage rehabilitation model (in the intensive care unit, during inpatient care, and in outpatient settings) and discusses several key directions: neurorehabilitation (neuroprotective agents, kinesiotherapy, sensory integration), nutritional support (enriched feeding, optimization of protein–energy balance, prebiotics and probiotics), and psychological support (family-centered early intervention model). Promising approaches that require further investigation include novel neuroprotective agents (xenon, darbepoetin, topiramate, melatonin, caffeine, metformin, hydrocortisone, RLS-0071, stem cells, and sovateltide) and mesenchymal stromal cell secretome therapies. Despite the importance of this issue, the rehabilitation of children after neonatal sepsis remains a field with a low level of evidence. This review systematizes the available evidence, highlights the need for further research to develop evidence-based rehabilitation programs, and to establish individualized rehabilitation trajectories aimed at improving long-term outcomes and quality of life in neonates.
Surgical treatment of children with congenital anterior dislocation of the tibia: a review
Congenital anterior dislocation of the tibia is a rare orthopedic disorder with an incidence of 1 per 100,000 newborns. Due to its low prevalence and a limited number of studies, no unified algorithm for surgical treatment of this condition has yet been developed when conservative treatment fails. A search of recent scientific data was conducted in PubMed, Scopus, eLIBRARY.RU, CyberLeninka, and Web of Science databases using the following keywords: врожденный передний вывих голени / congenital dislocation of the tibia, хирургическое лечение врожденного переднего вывиха голени / surgical treatment of congenital anterior dislocation of the tibia, and врожденный вывих коленного сустава / congenital dislocation of the knee joint. A total of 150 sources were analyzed, and 40 publications containing data on surgical treatment of congenital anterior dislocation of the tibia were selected. Various surgical techniques are currently employed, but their effectiveness remains debatable. The article presents an analysis of existing surgical methods for the treatment of congenital anterior dislocation of the tibia, examines their advantages and limitations, and identifies key challenges requiring further investigation. Surgical correction of this condition is most often employed in resistant and syndromic forms, which are frequently associated with knee stiffness, tibial flexion contracture, and weakness of the extensor mechanism. Therefore, when planning the use of surgical treatment techniques, it is crucial to consider the individual characteristics of the patient, such as the severity of the dislocation and the presence of concomitant somatic and orthopedic condition.
Fibro-adipose vascular anomaly in an adolescent: a case report
Fibro-adipose vascular anomaly is a relatively rare and only recently described disorder with distinctive clinical, radiological, and pathomorphological features. It is crucial for physicians to be fully aware of this condition to ensure timely diagnosis and early initiation of treatment. This article presents the clinical case of a 17-year-old female with fibro-adipose vascular anomaly of the right leg. At the age of 7, she developed a painful lesion in the leg. Over time, the lesion progressively increased in size, accompanied by limb hypotrophy and restricted ankle joint mobility. At the healthcare facility of her place of residence, multiple ultrasound examinations and computed tomography angiography were performed, which led to the diagnosis of mixed angiodysplasia of the right leg. Conservative measures, including physical therapy, compression garments, and orthopedic footwear, were ineffective. Disability was established at the age of 13. At 17, the patient was admitted to the Russian Children’s Clinical Hospital (Moscow). Examination revealed shortening of the right leg and foot, a firm painful mass in the upper third of the leg, hypotrophy of the thigh and calf muscles, and ankle contracture. Ultrasound examination revealed a hyperechoic lesion with indistinct outer margins in the muscles of the upper third of the leg, containing abnormally formed venous vessels with multiple phleboliths. Magnetic resonance imaging of this area confirmed the presence of vascular malformation. Angiography was additionally performed to clarify the angioarchitecture of the lesion and determine the possible extent of resection, leading to the diagnosis Q27.8—fibro-adipose vascular anomaly of the right leg. Given the impossibility of radical surgery due to subtotal involvement of the posterior muscle group of leg, the high risk of progression, pain, and impaired function, anti-proliferative therapy with sirolimus was initiated. Rehospitalization was scheduled after one year to assess treatment efficacy and reconsider surgical options. This case illustrates the challenges of delayed diagnosis, where long-term unrecognized disease progression resulted in disability and precluded one-stage radical treatment.
Surgical treatment of an adolescent with Blue rubber bleb nevus syndrome: a case report and review
Blue rubber bleb nevus syndrome (Bean syndrome) is a rare congenital venous malformation most frequently localized in the skin and gastrointestinal tract. Gastrointestinal involvement may manifest with recurrent intestinal bleeding, chronic anemia, and abdominal pain. This article presents a clinical case of a rare congenital disease in an adolescent and the use of a hybrid surgical approach for vascular malformations at multiple sites. The patient, a boy, was born with a vascular lesion in the area of the anterior fontanelle. In early childhood, he underwent neurosurgery for a cerebral angioma. At the age of 13, he developed abdominal pain and was diagnosed with severe anemia, requiring blood transfusion and iron supplementation. Due to persistent anemia, further evaluation was conducted at his local healthcare facility. Fibrocolonoscopy revealed and removed a vascular lesion in the transverse colon. Repeat fibrocolonoscopy demonstrated recurrent venous malformations and new vascular lesions. To clarify the diagnosis and determine further management, the patient was referred to the Federal Scientific and Clinical Center for Children and Adolescents of the Federal Medical-Biological Agency of Russia. Based on the history, clinical examination, and diagnostic findings, Bean syndrome was suspected. A combined (hybrid) surgical procedure was performed. At the first stage, diagnostic laparoscopy revealed multiple venous malformations in the parietal peritoneum and small intestine. At the second stage, under laparoscopic control of the intestinal wall at the sites of hemangiomas, endoscopic submucosal resection of the largest venous malformation in the sigmoid colon was performed. At the final stage of the hybrid operation, wedge resection of the jejunum with a vascular lesion was carried out. Histological examination confirmed venous malformations of the small and large intestines. The patient was referred to a specialized department for targeted sirolimus therapy. This case demonstrates the potential of combined surgical intervention in pediatric patients with multiple vascular malformations. A careful analysis of clinical and anamnestic data, together with laboratory and instrumental findings, made it possible to suspect this rare syndromic condition and to plan a staged hybrid laparo-endoscopic intervention.
Robot-assisted ureteroureterostomy in a child with mid-ureteral stricture: a case report
Congenital ureteral stricture in the mid-portion is a rare cause of upper urinary tract obstruction in children, and currently no established protocols for its surgical treatment exist. A retrospectively analyzed medical history is presented of a 2-year-old patient diagnosed with right mid-ureteral stricture, accompanied by impaired urinary outflow and reduced renal function. Ultrasound scanning and contrast-enhanced computed tomography were used to establish the diagnosis. Surgical treatment was performed using robotic assistance with resection of the stenotic segment and ureteroureterostomy. Intraoperatively, the proximal ureter was transected at the level of the narrowing toward the distal portion. The length of the resected healthy ureter corresponded to the diameter of the dilated segment. The ureteral anastomosis was created over a stent previously placed in the renal pelvis by cystoscopy. After preparation of the ureteral ends, the anastomosis was completed with subsequent drainage. The procedure was successful, with no intraoperative complications. Total operative time was 180 minutes, including 15 minutes for robotic docking. The entire operation was performed robotically without conversion to laparoscopy or open surgery. The stenotic segment measured approximately 8 mm. Postoperatively, the patient was monitored in the intensive care unit for 12 hours. He was discharged home 10 days after surgery, one day after Foley catheter removal. Histological examination of the stenotic segment revealed expansion of the submucosa with fibrosis, lymphocytic inflammation, and thickening of the muscular layer with fiber destruction. Four weeks after surgery, the ureteral stent was successfully removed by cystoscopy. In the long-term postoperative period, ultrasound examination revealed narrowing of the upper ureter to 4 mm. No stenosis was detected at the site of the ureteroureterostomy during follow-up. Robot-assisted laparoscopic ureteroureterostomy is a reliable and effective minimally invasive approach to the treatment of congenital mid-ureteral stricture, with no adverse short- or long-term outcomes during follow-up.
Hymenal atresia presenting as acute urinary retention in an 11-year-old girl: a case report
Hymenal atresia is a rare congenital anomaly of the female genital organs, typically diagnosed in adolescence after menarche. In some cases, diagnosis is challenging due to nonspecific symptoms that may mimic diseases of other organs and systems. This article presents a clinical case of an 11-year-old patient who had painful urination for one week. In the last 24 hours, she was unable to urinate on her own. She was taken by ambulance to N.F. Filatov Children’s City Clinical Hospital in Moscow. Initial evaluation revealed no obvious urological cause, necessitating further diagnostic workup. Medical history (absence of menarche), gynecological examination, and ultrasound revealed a dilated vagina filled with menstrual blood (hematocolpos), identified as the main cause of urethral compression and acute urinary retention. The underlying condition was congenital hymenal atresia. A urethral catheter was placed, draining 750 mL of urine. On the following day, cruciate hymenotomy under general anesthesia evacuated 300 mL of hemorrhagic content, followed by vaginal sanitation. A Foley catheter was inserted and removed on postoperative day 3. The patient received a short course of antibiotic therapy in the postoperative period. Urination was restored. She was discharged on postoperative day 5 in satisfactory condition under pediatric gynecologist supervision. This case may help raise awareness among surgeons about the possibility of imperforate hymen in adolescent girls presenting with urinary retention and periodic lower abdominal pain. In our case, gynecological examination and pelvic ultrasound confirmed hematocolpos and enabled timely surgical management.
Derivatives of Mullerian ducts in a phenotypically male child with unilateral nonpalpable testis: a case report
Persistent Mullerian duct syndrome is a rare disorder of sex differentiation characterized by the presence of a uterus, fallopian tubes, and a vaginal outgrowth of the urogenital sinus in boys with a 46,XY karyotype. One variant of persistence of Mullerian duct derivatives in a child with male external genitalia is the mosaic chromosomal anomaly 45,X/46,XY, which clinically manifests as an inguinal hernia or cryptorchidism. This article presents a rare clinical case of failure of Mullerian duct regression in a phenotypically male child with a unilateral nonpalpable testis. A 17-month-old boy was admitted electively to the surgical department of Children’s City Clinical Hospital No. 9 in Yekaterinburg with left-sided nonpalpable testis syndrome. Diagnostic laparoscopy revealed a rudimentary uterus and left fallopian tube with a structure resembling an ovary. Postoperatively, the child underwent further evaluation (histopathological examination, hormonal status assessment, karyotyping, molecular genetic testing, and urethrocystoscopy). The clinical diagnosis was established as “disorder of sex development caused by chromosomal abnormality 45,X/46,XY, mixed gonadal dysgenesis.” In cases where persistent Mullerian ducts are detected intraoperatively, current practice is limited to biopsy of the abnormal gonad, urethrocystoscopy for visualization of the urogenital sinus, and, when possible, catheterization of the rudimentary uterus with a ureteral catheter to visualize its location in the pelvic cavity. For diagnostic confirmation, karyotype analysis, molecular genetic testing, hormonal profiling, and evaluation by a geneticist and endocrinologist are performed. The final decision regarding the child’s sex assignment, after all additional examinations, is made by a medical board in consultation with the parents.
Amyand’s hernia in a two-month-old infant with extremely low birth weight: a case report
Amyand hernia is a congenital condition characterized by the presence of the appendix within the inguinal hernia sac, and it is a rare intraoperative finding in pediatric practice. This article presents the clinical case of a two-month-old infant admitted to the pediatric anesthesiology and intensive care unit of Volgograd City Emergency Clinical Hospital No. 7. The patient was one of twins, born with extreme prematurity (26 weeks of gestation) and an extremely low birth weight (900 g). The deterioration of the patient’s condition was associated with marked irritability, swelling, induration, and hyperemia of the scrotum extending to the pubic region and right inguinal area, laboratory-confirmed leukopenia with a left shift, and an increase in C-reactive protein to 149.2 mg/L. At admission to the surgical ward, the patient’s condition was severe. Body temperature was 37.8 °C. Consciousness was preserved, and the patient responded to examination with painful crying. Neurologically, diffuse hypotonia and decreased reflex activity were noted, along with weak oral automatism reflexes and rapidly fading spinal reflexes. Locally, edema and hyperemia were observed in the right inguinoscrotal region, with hyperemia extending from the scrotum to the right inguinal canal and pubic area. Palpation revealed a firm, elastic mass measuring 4.0×1.5–2.0 cm in the inguinoscrotal region distal to the internal inguinal ring, whereas the right testis was not identified separately. On the left side, an inguinal-scrotal hernia up to 4.0×3.0 cm was freely reducible into the abdominal cavity, without hyperemia. Emergency right-sided herniolaparotomy was performed. The hernia sac contained the appendix with a bulbous enlarged tip measuring 0.7×0.5 cm, palpably fluctuant. Appendectomy was performed using ligature technique. Histological examination of the resected appendix revealed signs of acute phlegmonous inflammation. The postoperative course was uneventful. On postoperative day 4, the infant was transferred to the Volgograd Regional Children’s Hospital with recommendations for elective surgery for the contralateral inguinal hernia. This case highlights that timely recognition, early surgical intervention, and an individualized approach to treatment significantly improve prognosis. Heightened vigilance, particularly in the context of prematurity and multiple organ immaturity, remains a key element for the successful diagnosis and treatment of this rare condition. In the analyzed case, the surgical intervention enabled timely diagnosis and prevented complications associated with the risk of appendix perforation, the development of peritonitis, and progression of inflammatory processes in the soft tissues of the inguinoscrotal region.
The 10th forum of pediatric surgeons of Russia
The 10th Anniversary Forum of Pediatric Surgeons of Russia was held on October 23–26, 2024, in Moscow at the Vega Izmailovo Hotel Complex. On the eve of the official opening, a Pre-Forum session took place, dedicated to the treatment of children with chest wall malformations. Among the speakers were leading experts from Russia as well as representatives from Argentina, Turkey, Switzerland, South Korea, and Kazakhstan. The plenary session of the Forum on October 24 included the ceremonial awarding of the S.D. Ternovsky Prize “For Outstanding Contribution to the Development of Russian Pediatric Surgery” to Professor Parshikov. His keynote lecture, “Pediatric Surgery—Notes of a Department Chair”, was devoted to the history of the specialty in Nizhny Novgorod and current challenges in the training of pediatric surgeons. The session opened with Kozlov’s report “Robot-Assisted Surgery—A New Reality in Pediatric Surgery.” A presentation by Razumovsky was dedicated to the memory of Professor Anatoly Fedorovich Dronov. The plenary concluded with a lecture by Morozov entitled “The Pediatric Surgical Service of the Russian Federation: The Work of the Institute of Chief Specialists.” The “How I Do It” video session featured 20 presentations showcasing original medical technologies. At the end of the first day, a meeting of the Pediatric Surgery Expert Commission of the Ministry of Health of Russia, chaired by Morozov and Razumovsky, was held. An unresolved issue for the participants was the discussion of the format and legal framework for involving general surgeons in providing emergency care for children. In total, the Forum program included: the plenary session, a video session, 14 symposia, 3 round tables, 2 master classes, a training session, a lecture, 3 thematic reports, an interactive panel discussion, a quiz, 4 Pre-Forum sessions, a meeting of the Pediatric Surgery Expert Commission of the Ministry of Health, a meeting of the Scientific Council of the Russian Association of Pediatric Surgeons, and a young researchers’ competition. The Forum was attended in person by 630 specialists. A total of 1,472 participants were registered. Online broadcasts of the events reached a total duration of 36.2 hours. On the final day, the traditional competition of young researchers’ scientific works was held. The 10th Forum of Pediatric Surgeons of Russia became an important milestone in the development of pediatric surgery in the Russian Federation, bringing together not only pediatric surgeons but also physicians from other specialties. The discussion of current issues in the format of live debate and online broadcasting enabled participants to outline directions for further development of pediatric surgery and opportunities for implementing modern medical technologies in daily practice.
In memory of Professor Alexey B. Okulov (October 2, 1937–August 1, 2025)
Russian pediatric surgery has suffered a great loss: on August 1, 2025, Alexey B. Okulov, Doctor of Medical Sciences, Professor, an outstanding physician, renowned pediatric surgeon, and one of the founders of Russian pediatric urology-andrology, passed away. Alexey B. Okulov was born in 1937 in Moscow. After graduating from the I.M. Sechenov Moscow Order of Lenin Medical Institute and completing his residency, his entire professional life was associated with the Central Institute for Advanced Training of Physicians (now the Russian Medical Academy of Continuous Professional Education). Within the team of talented staff of the Department of Pediatric Surgery under the leadership of Academician Doletsky, Okulov was formed as a surgeon, scientist, and teacher. Through his perseverance and dedication, he was able to develop new directions in pediatric surgery and operate at Rusakovskaya (now St. Vladimir) and Tushinskaya (now Z.A. Bashlyaeva) hospitals. His scientific legacy includes more than 500 publications. Without exaggeration, Alexey B. Okulov was a living legend of the Russian school of pediatric surgery, one of the pioneers of surgery for disorders of sex development in Russia, and a true mentor to many pediatric surgeons and urologists.