Vol 6, No 1 (2016)

Cover Page

Full Issue

EXCHANGE OF EXPERIENCE

THE POTENTIAL OF ULTRASOUND TECHNOLOGIES IN SURGICAL TREATMENT IN CHILDREN WITH SOFT TISSUE DEFECTS

Budkevich L.I., Mirzoyan G.V., Rozinov V.M.

Abstract

The article is devoted to an actual problem of pediatric surgery - the treatment of patients with infected wounds on the stages of the skin recovery. The authors analyzed the results of treatment of patients with wounds of various etiologies and demonstrate the efficiency of the use of ultrasonic cavitation and dissection in comparison as a method of preparation of the wound surface to plastic skin closure.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016;6(1):51-54
pages 51-54 views

SURGICAL ASPECTS OF TREATMENT CHILDREN WITH DEEP BURNS OF DORSAL SURFACE OF HANDS AND FEET

Bogdanov S.B., Babichev R.G.

Abstract

The article describes the experience of treatment of the hands and feet dorsal surface burns in children. In order to improve early necrectomy method with primary plastics, a method of nonperforated plastic skin autografts after necrectomy was developed. This method was performed under tourniquet which can reduce the operation time and intraoperative blood loss. This plastic without perforrhaphy allows to achieve good cosmetic results in the postoperative period as well as functional ones.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016;6(1):57-62
pages 57-62 views

CLINICAL OBSERVATIONS

THORACOSCOPIC CORRECTION OF CONGENITAL DIAPHRAGMATIC HERNIA WITH IMPLANT MATERIALS

Razumovskiy A.Y., Mokrushina O.G., Shumikhin V.S., Shchapov N.F., Smirnova S.V., Petrova L.V.

Abstract

This article shows the results of treatment of children with congenital diaphragmatic hernia (CDH) from 2008 to 2015. 133 infants with this malformation were operated in the City Children’s Hospital named after N.F.Filatov during the study period. In most cases, CDH correction were performed by thoracoscopic approach and defects were able to repair by own tissues. In cases of aplasia and hypoplasia of diaphragm the use of implant materials were required. Thoracoscopic diaphragm plasties with implant materials were performed in 39 children. During the analysis of the results revealed some advantages of biological implant «Permacol». The use of this type of material is allowed to carry out CDH correction with aplasia of the cupula of diaphragm, to obtain and maintain the achieved result in long-term follow-up.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016;6(1):87-92
pages 87-92 views

A CLINICAL CASE OF SIMULTANEOUS TREATMENT CHYLOTHORAX, CHYLOPERICARDIUM AND CHYLOPERITONEUM IN A NEWBORN

Kucherov Y.I., Yashina E.V., Zhirkova Y.V., Chebotaeva L.I., Moskvitina L.N.

Abstract

The article presents a clinical case of successful conservative treatment of a premature newborn with simultaneously-onset chylothorax, chylopericardium and chyloperitoneum. The nature of the effusion confirmed by biochemical studies and a predominance of lymphocytes. In intensive care used longterm parenteral nutrition, octreotide with increasing doses, mechanical ventilation and hunger. The duration of a full parenteral nutrition was 25 days. Enteral nutrition with gradual extension introduced after the complete disappearance of the liquid in the cavities on the 9th day from the beginning of therapy with octreotide. The child was discharged home at the age of 2 months 10 days. The article discusses the etiology, diagnosis and modern methods of intensive therapy of chylous effusion in neonates.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016;6(1):95-99
pages 95-99 views

TRANSUMBILIKAL APPROACH IN OPERATIONS ON THE LARGE SIZES OVARIAN CYSTS IN NEWBORNS

Spiridonov A.A.

Abstract

Laparoscopic techniques in the treatment of girls with tumor-like formations of the uterus are the priority at the last time. The article presents the results of operative treatment of two newborn girls with large ovarian cysts with open minimally invasive transumbilikal approach. The analysis of this clinical observations shows that use of minimally invasive open surgical approach is more gentle in some patients.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016;6(1):100-103
pages 100-103 views

SUCCESSFUL VENOARTERIAL EXTRACORPOREAL MEMBRANE OXYGENATION FOR LEFT DIAPHRAGMATIC HERNIA AND SUPRASYSTEMIC PULMONARY HYPERTENSION IN A NEONATE

Afukov I.I., Stepanenko S.M., Zilbert E.V., Kulaev A.D., Svetlichnaya T.O., Alkhasov A.B., Mitupov Z.B., Mokrushina O.G., Biryukov P.E., Strelkov V.A., Tsvetkov I.O.

Abstract

Extracorporeal membrane oxygenation (ECMO) was firstly used in 1977 for the treatment of congenital diaphragmatic hernia (CDH) in a neonate. The first time ECMO was administered in our country to a child with CDH on the 10th of January, 2013, at the intensive care department of Municipal Pediatric Hospital No. 13 named after N.F. Filatov. However, the first patient with CDH who had received ECMO, had survived decannullation and had been discharged from the hospital arrived to this hospital only on the 12th of October, 2015. The aim of ECMO was to stabilize the child’s condition and to obtain an opportunity of surgical correction of the congenital malformation. Indications included increasing cardiopulmonary failure, hypoxemia (РаО2<35 mm Hg, oxygenation index on the background of the high-frequency ventilation> 50, the alveolar-arterial oxygen gradient> 600 for 8 hours), combined acidosis, hypotension, suprasystemic pulmonary hypertension (main pulmonary artery pressure was higher than 100 mm Hg). There were no technical issues or complications during the procedure. Hemostatic therapy under the Activated Clotting Time (ACT) supervision, artificial lung ventilation (ALV), intravenous fluid and transfusion therapy were carried out. Cardiotonic therapy was canceled after the beginning of veno-arterial ECMO due to hemodynamic stabilization. Protective artificial ventilation was applied: VR-20; Pin-18mbar; PEEP-7mbar; FiO2-0,21. ACT was kept at 203 seconds in average at the average heparin infusion speed of 4 unit/kg/hour. Acidbase balance indicatiors: рН-7,38; РаО2-121,7 mm Hg, РаСО2-44,0 mm Hg, ВЕ-3,3, lactate 1,3. Average central venous pressure was 6,6 mm Hg., average invasive blood pressure - 51 mm Hg. After 72 hours of artificial circulatory support ECMO was canceled and surgical intervention was started after gas exchange and hemodynamic stabilization.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016;6(1):104-110
pages 104-110 views

ANNIVERSARIES

ANNIVERSARIES

Article E.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016;6(1):113-113
pages 113-113 views

ORIGINAL ARTICLES

FUNCTION OF THE KIDNEY TRANSPLANT AT CHILDREN IN THE EARLY AND LATE POSTOPERATIVE PERIODS

Morozov Y.A., Marchenko T.V., Goncharova A.V., Doletskaya L.G.

Abstract

The study evaluated the dynamics of the glomerular filtration rate (GFR) of renal transplant in children after donor kidney transplantation in the early and late postoperative period. The GFR of a donor kidney in the postoperative period after transplantation was found an average as 68.5±22.3 ml/min . Further, the figure changes at a rate of 1.7 ml/min per month. Postoperative graft function aggravation is primarily depended on the age of the recipient. Duration of pre-transplantation renal replacement therapy had did not affect on renal function recovery in the postoperative period. The children treated with peritoneal dialysis before transplantation had a higher GFR values after surgery then children treated with hemodialysis. These differences were leveled in a year.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016;6(1):8-15
pages 8-15 views

COMBINED NAVIGATING SURGICAL INTERVENTIONS IN CHILDREN WITH SOLITARY SPLENIC CYSTS

Belyaeva O.A., Kondrashin S.A., Polyaev Y.A., Garbuzov R.V., Musaev G.K., Bondar Z.M., Belyaeva A.V., Shiryaev A.A.

Abstract

In the period of time from 2000 to 2015 in the mentioned clinics were operated 40 children (4-17 years) with a non-parasitic splenic cysts. Preoperative examination included ultrasound investigation, CT or MRI scans, angiography of spleen vessels. This article presents the results of a comparative analysis of various treatment technologies effectiveness. In the first group (27) patients were carried out percutaneous drainage and sclerotherapy of cysts by 96% ethanol under the ultrasound navigation control. In13 patients (the second group) were performed combined surgery, which included superselective embolization of the arteries feeding cyst walls along with percutaneous drainage and sclerotherapy cysts. In catamnesis (up to 9 years) was found that the necessity of reoperation occurred in only 5 patients from the first group. The findings suggest that the combined navigating interventions have a lower risk of recurrence of splenic cysts and can be considered as operations of choice for intraparenchymal localization, which presents objective difficulties in laparoscopic approach.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016;6(1):16-23
pages 16-23 views

IMMEDIATE AND LONG-TERM RESULTS OF THE TREATMENT OF INTESTINE MALROTATION IN CHILDREN

Ergashev N.S., Sattarov J.B.

Abstract

This research is based on the analysis of immediate and long-term treatment results of children with intestinal malrotation (ok) (IM). The research was carried out basing on examination of 46 patients out of 74 patients with various forms of IM dismissed from hospital after open treatment or conservative management. The patients were treated in the hospital of pediatric surgery of TashPMI during the period from 2002 to 2013. The nature and frequency of post-surgery complications are described. Long-term results were evaluated as good - for 28 patients (66.7%), satisfactory - for 5 patients (11.9%), unsatisfactory - for 9 patients (21.4%). Inefficiency of conservative management is emphasized. Frequently observed chronic colostasis of various intensity and abdominal pains in the long-term period after the treatment were, in most cases, related to total or segmental colon elongation.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016;6(1):24-29
pages 24-29 views

INTERMITTENT BLADDER CATHETERIZATION IN THE REHABILITATION OF CHILDREN WITH MYELODYSPLASIA SYNDROME

Menovschikova L.B., Nikolaev S.N., Kovarskiy S.L., Sklyarov T.A., Sottaeva Z.Z.

Abstract

Intermittent catheterization in children with myelodysplasia syndrome involves repeated draining the bladder at the regular intervals during the day using a urethral catheter. Such a procedure against the background of preserved (or restored) reservoir bladder function not only replaces the evacuation function, but also reduces the frequency of leukocyturia and bacteriuria and contributes to the development of a conditioned reflex of urinating. Adequate supply of evacuating function of the bladder, an abort of infectious complications, restoration of urodynamics of the upper urinary tract make the intermittent catheterization the most optimal way of rehabilitation.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016;6(1):30-36
pages 30-36 views

THE MORPHOLOGICAL CHARACTERISTICS OF THE BIOPSY IN CHILDREN WITH SPINAL DYSRAPHISM

Shamsiev A.M., Aliyev B.P., Nikolaev S.N., Baibekov I.M., Shamsiev J.A.

Abstract

Biopsies of removed spina bifida and regional tissue in 21 children (before the age of 1 year) who were operated on meningoradiculocele and 18 biopsies in combination with congenital intradural malformations were exposed to morphological study. Retrospective analysis of histological features of the various forms of spina bifida identified an objective assessment of expediency of different methods of surgical treatment according to the form of malformation. The results showed that skin covering the area of all forms of spina bifida is characterized by distinct polymorphism. At the same time the specific changes of epidermis were not found in the various forms of spina bifida. The often result of operations, which were conducted outside of a specialized agency, is aggravation of the disintegration and demyelization processes caused by secondary arachnoid, soft and dura mater adhesions, greater involvement of the spinal cord pathways and roots in the adhesions, severe disorders of local hemodynamics.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016;6(1):38-46
pages 38-46 views

DIAGNOSTICS OF COMPLICATED NEPHROLITIASIS IN CHILDREN

Mahmadjonov D.M., Sultonov S.R., Sattorov A.M.

Abstract

The authors carried out 226 managements of patients with complicated nephrolithiasis in the age from 1 to 15 years. The risk factors of nephrolithiasis in 87% of cases were maternal diseases, related marriages and various pathologies aggravating the primary condition. Urinary tract anomalies were found in 35.8% of cases. In 61.5% of cases excretory urography showed kidney dysfunction. Calculous pyelonephritis (up to 81.7%) was the most frequent complication, each second child (49.7%) had calculous hydronephrosis. In 86.1 % of early childhood patients nephrolithiasis was observed on the background of somatic and urological pathologies. Intraoperative incisional biopsy allowed to define the criteria of combined kidney injury by hydromechanical and pyelonephritic processes, and also various dysplastic changes of kidney parenchyma.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016;6(1):47-50
pages 47-50 views

NECROLOGUES

ПАМЯТИ САЛТАНОВА АЛЕКСАНДРА ИОСИФОВИЧА

Article E.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016;6(1):116-117
pages 116-117 views

ПАМЯТИ ШАФРАНОВА ВЛАДИМИРА ВАСИЛЬЕВИЧА

Article E.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016;6(1):118-119
pages 118-119 views

SCIENTIFIC REVIEWS

FOKER PROCEDURE - STRATEGY OF INDUCTION OF THE ESOPHAGEAL GROWTH BY TRACTION

Foker J., Kozlov Y.A.

Abstract

The scientific review is devoted to study of treatment of long gap esophageal atresia with use of traction elongation. This surgical method is rather new and unknown for readers from the Russian Federation. From first-hand authors first-hand showed versatile aspects of extension of esophagus.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016;6(1):63-73
pages 63-73 views

"OLD AND NEW" PROBLEMS OF INFUSION THERAPY FOR PATIENTS IN ACUTE PERIOD OF SEVERE BURNING INJURY

Lekmanov A.U., Azovsky D.K., Pilyutik S.F.

Abstract

The review of literature discusses modern trends of infusion therapy for children and adults in acute period of severe burning injury. The authors used PubMed and Google Scholar to search for the primary terms and the data of own research. The conclusion is that the formulas used for infusion volume calculations often lead to significant fluid of affected person and serious complications. In order to avoid such an overload the authors suggest key points of infusion therapy using invasive monitoring of hemodynamic in children and adults with acute burning traumas.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016;6(1):74-81
pages 74-81 views

ETIOLOGY AND PATHOPHYSIOLOGY OF CHRONIC INTESTINAL PSEUDO-OBSTRUCTIVE SYNDROM IN CHILDREN. PART I. INTESTINAL MOTILITY PHYSIOLOGY

Averyanova Y.V., Razumovsky A.Y., Stepanov A.E.

Abstract

Chronic intestinal pseudo-obstruction (CIPO) is a rare syndrome characterized by dilatation of the bowel lumen and abnormal motility in which no mechanical cause is identified. The syndrome appears at the background of congenital or acquired neuropathy, myopathy, or neuromyopathy. The article discusses the specifics of aetiopathogenesis of different disease forms, including de nova mutations discovered during the last decade. The article may be interested for surgeons who must be able to detect intestinal pseudo-obstruction to avoid unnecessary surgical interventions and also for other specialists who may encounter the syndrome in their practice.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016;6(1):82-86
pages 82-86 views

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