Vol 7, No 2 (2017)

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Full Issue

ORIGINAL ARTICLES

COMPARATIVE ESTIMATION OF TREATMENT RESULTS IN DIFFERENT METHODS OF THORACOPLASTY IN CHILDREN WITH PECTUS EXCAVATUM

Razumovsky A.Y., Alkhasov A.B., Mitupov Z.B., Dallakyan D.N., Savelieva M.S.

Abstract

The purpose of the study: to compare the results of treatment of  patients with pectus excavatum in different methods of thoracoplasty in children

Materials and methods: 542 patients with pectus excavatum were  operated from 1996 to 2016. For the purpose of comparative  estimation, the patients operated using various methods were  divided into two groups. The first group included 90 children who  underwent surgery using the method of Salamaa-Paltia. The second  group embraced 452 patients using the Nass procedure of modified  thoracoplasty. The following parameters were estimated and  compared for the groups: surgery duration, length of epidural  anesthesia, duration of anesthetics intake, intra- and postoperative complications, number of days spent at the hospital following the surgery. 

Results: no epidural anesthesia was given to the patients from the  1st group. The children who underwent a surgery received narcotic  analgesics combined with non-steroid anti-inflammatory agents  prospectively. The protocol of postoperative analgesia of the 2nd  group included prolonged epidural anesthesia combined with non- steroid anti- inflammatory agents. Narcotic analgesics were used  only when the above mentioned agents failed to stop the pain  syndrome. Thoracoscopy was performed in 9 (1.9%) of patients. Simultaneous surgeries were done in 10 (2.2%) patients. Groups I  and II have significant differences as related to the time of an  operation and intraoperative blood loss. The surgery duration using  the Salmaa-Paltia procedure 2.7 times exceeded the length of  thoracoplasty using the modified Nass procedure; intraoperative blood loss was 4 times as much.

 

Conclusions: the modified Nass procedure to correct the pectus  excavatum is safe and effective in most cases including syndrome- based forms of the disease and enables to obtain an excellent  cosmetic result. It reduces the risk of such complications as damage  to the chest organs during a surgery and displacement of the plate  during the postoperative period.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2017;7(2):7-12
pages 7-12 views

ULTRASOUND DIAGNOSTICS OF VARICOCELE IN CHILDREN

Komarova S.Y., Tsap N.A., Karachev I.A.

Abstract

Rationale: complex objective diagnostics of varicocele in children of different age often leads to unnecessary surgeries.

Purpose: to study sonographic peculiarities of varicocele in children  stratified by age, and develop classification criteria of varicocele depending on the age.

Materials and methods: we presented the results obtained during  a complex ultrasound examination involving 199 boys and  adolescents treated at the department of urology and andrology of  the Municipal Autonomous Institution Children’s Municipal Clinical Hospital No. 9.

Conclusion: Adherence to the algorithm of ultrasound examination  during varicocele diagnostics in children of different age provides for  an adequate therapy.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2017;7(2):13-18
pages 13-18 views

ESTIMATING THE FUNCTIONAL STATE OF THE HIP JOINT AND LIFE QUALITY AFTER SURGICAL TREATMENT OF LEGG-CALVE-PERTHES DISEASE

Golovkin S.I., Shabaldin N.A., Titov F.V., Krasavin G.N., Bakovsky V.B., Gibadullin D.G.

Abstract

Purpose: comparative analysis of the functional state of the hip  joint and life quality in children following various types of surgical  treatment of Legg-Calve-Perthes disease.

Materials and methods: the surgery was performed in two groups  of patients with Perthes disease. In the first group consisting of 12  children, the proximal portion of the femur was stabilized using a L- shaped plate. In the second group, 29 patients were operated using  the internal method and intramedullary titanium elastic nail (TEN)  fixation. According to TEN, medialization, varization and elimination  of the epiphyseal subluxation of the femoral fragment are performed immediately using two flexible elastic rods.  Functional capabilities of the operated joint were estimated  radiologically and using the Iowa Hip Score. Patients (n=41) operated using various methods
were included in the perspective health-related study of life quality.  They used the MOS 36‑item short-form health survey.

Results: dynamics of restoration of the operated joint using the  proposed method occurred from 1.5 to 1.7 years in one group, and  within 2.4 years in the other group. Analyzing the results obtained in the study of functional outcomes and life quality, we  found the advantages of TEN osteosynthesis in treatment of Legg- Calve-Perthes disease in children leading to the soonest positive  physophysical treatment result.

 

Conclusion: pathogenetically substantiated method of surgical  treatment of the 2nd and 3rd stage of Legg-Calve-Perthes disease in  children is intramedullary titanium elastic nail (TEN) fixation. The  minimally invasive and effective method of surgery promotes early  vertical orientation of the patient without specific prevention of  depressive and asthenic states and improves the patient’s life quality in the early and remote period.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2017;7(2):19-27
pages 19-27 views

SURGICAL TREATMENT OF EXTRAVASAL COMPRESSION OF MAJOR VEINS IN CHILDREN

Garbusov R.V., Polyaev Y.A., Mylnikov A.A., Sukhov M.N.

Abstract

Rationale: angiodysplasia may account for about 5% of all cases of  vascular abnormalities. Patients with angiodysplasia of pelvis and  lower limbs constitute half of the total amount of persons suffering  from that disease. Patients with venous dysplasia relate to the most  numerous group of those with angiodysplasia.

Purpose of the study: determine basic syndromes found in  extravasal compression of the venous bed in children, determine the  pathogenetic value of the syndromes during formation of the venous  pathology in children and adolescents and develop the treatment method of the pathology.

Materials and methods: The following surgeries were performed:  transposition of the right common iliac artery and balloon  angioplasty in May-Thurner syndrome, formation of gonadoiliac anastomoses in phleborenohypertension, and removal of  the cervical rib in venous type of the thoracic outlet syndrome (TOS).

Results and their discussion: The main causes of small pelvis  varices were as follows: valvular insufficiency (ovaricovaricocele and  varicocele) in 2 of 3 of cases, aortomesenterial compression, in May- Thurner syndrome in 1 of 3 cases. The thoracic outlet syndrome (TOS) was found in eleven patients.

Conclusions: staged balloon angioplasty combined with removal or  hardening of veins can be the method of choice in patients with  moderate May-Thurner syndrome. Transposition of the right CIA can  be the method of choice in patients with severe May-Thurner  syndrome. Gonadoiliac shunting is chosen in patients with small  pelvis varices associated with mesoaortic compression. Removal or  resection of the cervical rib is done in patients with the thoracic  outlet syndrome due to the additional cervical rib.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2017;7(2):28-38
pages 28-38 views

RESULTS OF TREATMENT OF CHILDREN WITH ACUTE KIDNEY DAMAGE

Muzurov A.L., Abaseeva T.Y., Generalova G.A., Pankratenko T.E., Emirova K.M., Orlova O.M., Kvaratskheliya M.V., Popa A.V.

Abstract

The aspects of present-day terminology and classification of acute  kidney injury are considered in the article. Retrospective study of  245 patients with AKI over the last 5 years was performed. The analysis of AKI severity depending on pediatric classification  RIFLE criteria was performed. It had shown that the RIFLE classification is highly informative for predicting disease outcome It  had shown that the anuria duration period constituted on the average 12.1±6.4 days. Renal replacement therapy was required  in 72.2% of patients, and conservative treatment turned  out to be effective in 27.8% children. The study demonstrated that requirement in renal replacement therapy and/or neurological disorders presence and the need of performing artificial lung  ventilation is the predictor of poor prognosis in children with AKI.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2017;7(2):39-44
pages 39-44 views

OPTIMIZATION OF FEEDING IN CHILDREN WITH COLON AGANGLIOSIS RECEIVING A PROBIOTIC THERAPY

Sytkov V.V., Poddubny I.V., Borovik T.E., Yatsyk S.P., Dyakonova E.Y., Kozlov M.Y., Malashenko A.S., Okulov E.A.

Abstract

The article discusses an issue of prescribing probiotics and enteral  nutrition products in children with colon agangliosis. In a prospective  study, it was found, that the use of a qualitative stool test for  Clostridium difficile toxins A and B during pre-operative period of Hirschsprung disease helps to determine the tactics for antibacterial  therapy, and the integrated use of a probiotic preparation and an enteral nutrition product in the perioperative period plays an important role in the prevention of severe complications, such as enterocolitis and antibiotic-associated diarrhea.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2017;7(2):45-50
pages 45-50 views

OBSERVATIONS FROM PRACTICE

TREATMENT OF THE CHILD WITH GENERALIZED TETANUS

Petlakh V.I., Kuz'menko T.N.

Abstract

The paper presents a case of the generalized form of severe tetanus in a 9‑year-old child with a relatively short incubation period. Decisive in preserving the life of the patient were complex efforts of specialists of different profiles: infectious diseases, resuscitators, pediatricians,  but only active surgical tactics provided a favorable result of the disease.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2017;7(2):51-54
pages 51-54 views

DUODENAL FOREIGN BODIES IN A CHILD

Averin V.I., Pataleta O.A.

Abstract

The authors describe a rare clinical observation of a duodenal foreign  body that caused severe intestinal obstruction in a child.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2017;7(2):55-58
pages 55-58 views

A RARE CAUSE OF ABDOMINAL PAIN SYNDROME IN A 9-YEAR-OLD GIRL

Labuzov D.S., Tarasov A.A., Savchenkov A.L.

Abstract

An own clinical observation of vascular malformation of ileac mesentery with torsion around the peduncle and strangulation in the  right inguinal canal in a 9-year-old girl is presented. The girl was admitted for suspected acute appendicitis. Diagnostic laparoscopy, laparoscopic removal of the fixed formation and its video-assisted removal were carried out considering lack of obvious clinical and laboratory signs of acute appendicitis and pain syndrome preservation. The clinical case shows that it is possible to come across a rare cause of abdominal pain syndrome reconfirming the diagnostic value and therapeutic possibilities of laparoscopy.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2017;7(2):59-61
pages 59-61 views

SCIENTIFIC REVIEWS

EPIDEMIOLOGY OF ACUTE KIDNEY INJURY IN CHILDREN

Kimura K., Kozlov Y.A.

Abstract

The article is based on the memories of a great pediatric surgeon of the XX century, which are of historic interest for pediatric surgeons of today. Our colleague Ken Kimura who is an honorable professor of surgery of Iowa state have demonstrated his scientific view of the most discussed issue of effective treatment of duodenal atresia within the last decades. We collaborated with him to describe the operation, which is currently named after him, and added original pictures of surgery stages in the form of illustrations made at the time when the anastomosis was created.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2017;7(2):62-67
pages 62-67 views

ENDOCHIRURGICAL TREATMENT OF CHILDREN WITH LYMPHANGOMAS OF RARE LOCALIZATION

Bataev S.M., Afaunov M.V., Ignatyev R.O., Zurbaev N.T., Fedorov A.K., Bogdanov A.M., Molotov R.S., Ludikova M.Y., Oleynikova Y.V., Smirnova S.E.

Abstract

The article presents two cases from the clinical practice of treating children with lymphangiomas with rare localization: on bladder and on sigmoid colon. In both cases, surgical interventions were performed using laparoscopic techniques. Good results of treatment with proven clinical outcomes and instrumental studies allow to speak with confidence about the possibility of using minimally invasive surgical techniques when performing radical surgery in these patients.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2017;7(2):68-73
pages 68-73 views

ХРОНИКА НАУЧНОЙ ЖИЗНИ

REPORT OF THE WORK OF THE INTERNATIONAL FORUM "SURGERY AGAINST TERRORISM: SURGERY OF DAMAGES. ERRORS, DANGERS, COMPLICATIONS"

Petlakh V.I.

Abstract

The paper summarizes the reports on the surgical forum, devoted to the problems of medical care in terrorist attacks and serious injuries.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2017;7(2):74-79
pages 74-79 views

ANNIVERSARIES.

artical E.

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Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2017;7(2):80-81
pages 80-81 views

LETTERS TO THE EDITOR

artical E.

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Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2017;7(2):82
pages 82 views

NECROLOGUE

artical E.

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Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2017;7(2):83-84
pages 83-84 views

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