Vol 7, No 4 (2017)

Cover Page

Full Issue

Historical Articles

BIRTH OF PEDIATRIC SURGERY IN RUSSIA (115TH ANNIVERSARY OF THE UNITED MEETING OF THE SECTIONS OF SURGERY AND PEDIATRIC DISEASES OF THE CONGRESS IN THE MEMORY OF PIROGOV)

Morozov D.A., Ayrapetyan M.I., Pimenova E.S.

Abstract

The article is devoted to the fi Russian United Meeting of the Sections of Surgery and Pediatric Diseases of the VIII Congress of the Russian Doctors in memory of N. I. Pirogov held in 1902 discussing the issues of pediatric orthopedics, treatment of appendicitis and angiomas in children. The outstanding role of the head physician of St. Olga’s pediatric hospital, fi private-docent in pediatric surgery of theMoscowImperialUniversity(1893-1896) and founder of pediatric surgery as a science Leontiy Petrovich Aleksandrov is stressed. A brief characteristic of the surgeons and pediatric doctors participating in the scientifi discussion such as E. V. Pavlov, V. I. Razumovsky, I. A. Praxin, K. H. Horn, T. P. Krasnobaev, A. A. Bobrov, A. A. Kisel, V. G. Tsege-vonManteuff and N. S. Korsakov is provided.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2017;7(4):7-17
pages 7-17 views

Case reports

A CASE OF CHYLOPERITONEUM DEVELOPMENT IN A 5-MONTH OLD

Bocharov R.V., Pogorelko V.G., Varlamov K.G., Karavaev A.V., Yushmanova A.B.

Abstract

A case of successful chyloperitoneum therapy in a 5-month-old infant was analyzed. Clinical and laboratory picture of pathology, visual morphological changes in the abdomen are described and the peritoneal effusion using objective markers is evaluated. The complex therapy uses modern methods such as intestinal unloading, complete parenteral nutrition, correction of electrolyte and protein balance, octreotide (somatostatin synthetic analogue).

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2017;7(4):78-80
pages 78-80 views

Original Study Articles

RESULTS OF SURGICAL TREATMENT OF NEWBORNS WITH OMPHALOCELE

Kozlov Y.A., Novozhilov V.A., Rasputin A.A., Baradieva P.I., Zvonkov D.A., Timofeev A.D., Rasputina N.V., Kuznetsova N.N.

Abstract

The surgical treatment results for 27 patients with omphalocele taken to the Ivan-Matryona Children’sClinicalHospitalinIrkutskfrom 2002 to 2017 were submitted. The study methodology consists in the comparative analysis of effectiveness of different surgical technologies including one-step (17 patients) and stage (10 patients) abdominal wall defect repair. ALV duration, time of transition to complete parenteral nutrition, hospital stay duration, gastroesophageal reflux occurrence, ventral hernia and lethality are used as comparison criteria. There are no significant differences between the groups of patients randomized by gestational age, afterbirth age and body weight. Significant disturbances by extubation period were stated (1.76 vs 5.4 days, p=0.0001).

A significant decreased transition time to complete enteral nutrition (20.53 vs 27.60 days, p=0.020) was observed in the group of one-stage defect closure. Fundoplication frequency was higher in those patients who underwent multistage surgeries (11.76% vs 30%, p=0.326). Ventral hernia formation frequency was also higher in the group of stage closure (8.57% vs 30%, p=0.128). Study results reveal the advantage of one-stage abdominal repair in surgical treatment of newborns with omphalocele.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2017;7(4):18-25
pages 18-25 views

A NEW METHOD OF HERNIOTOMY IN CHILDREN WITH AN UMBILICAL HERNIA

Svarich V.G., Lisitsyn D.A., Islentiev R.N., Perevozchikov E.G.

Abstract

A surgery for umbilical hernias was performed in 1636 children at the surgical department of the Republican Children’s Clinical Hospital of Syktyvkar from 2007 to 2017. All the patients were divided into two groups. The first group included children who underwent herniotomy by Lekser. 1296 (79.2%) of the patients were operated until 2016. The second group included 340 (20.8%) of patients who had been operated using a new method of herniotomy since 2016. 29 patients (2.2%) who had undergone herniotomy by Lekser had postoperative complications. 26 children had a suture sinus of the surgical scar and 3 children developed a recurrence. No complications were found in the group of patients who had been operated using a new method of herniotomy. It is established that intra-operative and post-operative examined parameters were significantly better in the second compared group.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2017;7(4):53-57
pages 53-57 views

PREVENTIVE ORCHIOPEXY IN TREATMENT OF CHILDREN WITH TESTICULAR TORSION

Shedrov D.N., Beresnyik I.A.

Abstract

Materials and methods: 472 case histories of patients with testicular torsion were analyzed. In 24 cases, there was a bilateral asynchronous testicular torsion. Preventive fixation of the contralateral gonad followed the first episode of torsion as per the original method.

Results: a more favourable course of contralateral testicular torsion was demonstrated in spite of the similar torsion degree due to the fastest appealibility as parents and patients are well informed. It is shown that the contralateral testicular fixation has no complications being an effective means of asynchronous torsion prevention.

Conclusion: preventive contralateral orchiopexy is indicated to all patients with testicular torsion as it effectively prevents the asynchronous torsion and has no complications.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2017;7(4):64-68
pages 64-68 views

TREATMENT OF ARTERIAL HYPOTENSION IN NEWBORNS WITH EXTREMELY LOW GESTATIONAL AGE (LECTURE)

Mitkinov O.E.

Abstract

The article explores modern ideas of how to manage premature newborns with arterial hypertension. In this population of patients, hypotension with the level of the mean blood pressure below the gestational age is considered prognostically unfavourable. Standard therapy includes volemic bolus with NaCl 0.9% and inotropic support (more frequently represented by dopamin to 10 µg/kg/min). Analysis of modern literature shows that the approach is not always successful. Arterial hypotension proper must not be the reason for therapy initiation as parallel analysis of clinical and echocardiographic signs is necessary.

Echocardiography aims at the evaluation of contractility of the myocardium and systemic blood flow and exclusion of hemodynamically significant arterial duct and pulmonary hypertension. Volemic bolus is given upon respective indications and dobutamine can be considered as the 1st line inotropic agent in the majority of cases. Early administration of hydrocortisone is reasonable in resistant hypotension.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2017;7(4):69-77
pages 69-77 views

FOREIGN BODIES IN THE GASTRO-INTESTINAL TRACT OF CHILDREN

Babich I.I., Bagnovsky I.О.

Abstract

In recent years, the number of patients with foreign bodies of the alimentary tract, which require hospital treatment, has increased signifi . In some cases, complications occur leading to fatal outcomes or requiring complex reconstructive surgeries. Purpose: to improve the results of treatment of patients with foreign bodies of the alimentary tract by developing diagnostic and therapeutic tactics.

Materials and methods: The subject of the study was 323 patients who were on treatment at the CSTO in Rostov-on-Don between 2010 and 2016. The main attention was paid to aggressive foreign bodies: alkaline batteries and magnets.

Results: Aggressive foreign bodies were removed as soon as possible under the FGDs. Alkaline batteries, if swallowed, caused electrochemical burns. The first degree burn was found in 12 patients (3.7%), in grade II in 8 patients (2.5%), in grade III in 10 (3.1%), in grade IV in 1 patient (0.3%). For foreign magnetic bodies, double-barreled ileostoma was excreted in 5 cases (1.5%), resection of the intestinal loops was performed in 3 cases (0.93%) with end-to-end anastomosis applied.

Conclusions: If aggressive foreign bodies are detected in the esophagus and stomach, the latter must be removed as soon as possible under the FGDs. Severe burns of the esophagus III–IV require treatment with the placement of a probe for enteral nutrition and the introduction of drugs through the mouth into the esophagus that accelerate regeneration. When identifying clinical and radiological predictors of peritoneal complications, it is necessary to move to active surgical tactics.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2017;7(4):26-30
pages 26-30 views

EXPERIENCE WITH A FREE FULL-SICKNESS EXTENDED SKIN GRAFTS IN TREATMENT OF CHILDREN WITJ SKIN EXTENDED DEFECTS

Rybchenok V.V., Trusov A.V., Tscherbakova М.A., Fomina M.G., Starostib О.I.

Abstract

Study purpose: to evaluate the effectiveness of the new method of treatment of children with wide skin defects.

Materials and methods. The method of reconstructive surgery using a free full-sickness extended skin graft was applied in 15 children. The treatment was rendered based on Speransky Children’s City Clinical Hospital No.9 of Moscow from 2010 to 2016.

Results. Upon acceptance of a graft in all patients, the treatment resulted in a considerable clinical improvement such as removal of cicatrical tissues and contractures, and elimination of extensive skin defects in functionally and cosmetically significant anatomical areas. Out of 16 treatment episodes, there were 3 cases (18.5%) of clinically significant postoperative complications (graft lysis, expander suppuration).

Conclusion. Reconstructive surgeries using a free full-sickness extended skin graft enable to obtain good cosmetic and functional results in children with extensive skin defects.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2017;7(4):58-63
pages 58-63 views

UPPER URINARY TRACT INTERNAL DRAINING AS A COMPONENT OF COMPLEX TREATMENT OF CONGENITAL HYDRONEPHROSIS IN CHILDREN

Rumyantseva G.N., Kartashyov V.N., Burchyonkova N.V., Avrasin A.I., Medvedev A.A.

Abstract

The work analyzes the results obtained during the treatment of 285 children with congenital hydronephrosis aged 3 months to 17 years. Hynes-Andersen caliceal plasty was performed in 200 patients, nephrectomy – in 56 patients and internal renal drainage (as the main method of treatment) – in 17 patients. 192 resected caliceal segments underwent a histological examination.

In 26 preparations (13.5%) of young children only inflammatory changes were discovered. This led to surveillance review of patients with hydronephrosis of all grades in young patients using small invasive endoscopic interventions aimed at the restoration of caliceal urodynamics. We used endoscopic appliances, urethral catheters and stents for preliminary bougienage and drainage of an affected organ with the examination of preliminary results.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2017;7(4):31-37
pages 31-37 views

RUSSIAN REGISTER OF CHILDREN WITH SHORT BOWEL SYNDROM

Rosinov M.V., Chubarova A.I., Erpuleva Y.V., Averianova U.V., Demura S.A., Kosov D.A.

Abstract

The Russian register of children with the «short bowel syndrome» (SBS), as a system for the regular collection, monitoring and analysis of unified clinical data on the profile patients, is created on the online platform Quinta, intended for scientific and clinical healthcare purposes.

Material and methods. In the first year of the register, information was collected on 126 children with SBS living in 42 regions of Russia who were being treated in 54 medical organizations. The analysis included anamnestic, demographic and clinical data included in the patient’s medical records.

Results. The prevalence of the SBS was 6.31 cases per 1,000,000 children under the age of 18 years. The majority (63.5%) of the patients were represented by young children. Congenital malformations and malformations were the leading (73.0%) in frequency cause of performing various surgical interventions followed by the development of SBSs. More than half (51.8%) of patients suffered 2–3 surgical interventions preceding the development of the SBS. A critically small extension of the small intestine (less than50 cm) was found in 63% of patients. Reconstructive plastic surgery aimed at increasing the area of the functionally active suction surface of the intestine was performed in 29 patients. Complete restoration of intestinal autonomy was achieved in 4 patients.

The conclusion. The register is intended to improve the quality of medical care for patients with SBS on the basis of forming a single professional information space for expert support of medical decisions, interdisciplinary interaction of specialists, monitoring of basic medical, social and resource indicators, and objective evaluation of the effectiveness of various medical technologies.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2017;7(4):38-45
pages 38-45 views

SHORT BOWEL SYNDROME AND CHRONIC INTESTINAL FAILURE: ASSESSMENT OF PROGNOSTIC MARKERS AND EFFECTIVENESS OF REHABILITATION

Chubarova A.I., Kostomarova E.A., Zhikhareva N.S.

Abstract

Introduction. The survival rate of children with chronic intestinal failure (IF), a special case of which is short bowel syndrome (SBS), is increasing nowadays. The experience of a 4-stage system of care for children with chronic intestinal failure (IF) and short bowel syndrome (SBS) developed in Children’sCityHospital named after N. F. Filatov is presented. 

Objectives. The aim was to identify prognostic markers for intestinal adaptation (IA) in children with an extended (more than50 cm) resections of the intestine.

 Methods. The outcomes were evaluated in 75 children one year after resection and its relations to the preserved small intestine length, extension and cause of resection.

 Results. Survival of children after 1 and 3 years was 87–89%. The proportion of those who have reached IA was higher (38%) in children with more than60 cm remaining intestine in comparing to those who have less than30 cm and 30–60 cm of intestine (14.5–15%) (p <0.05. After combined resections of intestine and colon more children were dependent on PN (90%) then after intestinal (46%) or colon resections (41%) (p <0.05). Children with acute strangulation and intestinal malformations better achieved IA (50% and 44%) compared with those who underwent resection for necrotizing enterocolitis or diff intestinal neuroand myopathies (0% of IA by 1 year after resection) (р<0,05). By 1 year of following up (N=75) 25% achieved IA, 46% remained dependent on the PN, by 3 years (N=32) 44% achieved IA, 39% were dependent on PN. Conclusion. The remaining intestinal length, extension of resection and the underlying disease infl on 1-year prognosis in children with intestinal resections. Increasing in those who have achieved AI in the course of time allows to conclude that children with IF and SBS have a rehabilitation potential and the developed RP is eff in such patients.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2017;7(4):46-52
pages 46-52 views

News

THE RESULTS OF THE III CONGRESS OF PEDIATRIC SURGEONS OF RUSSIA. Moscow, October 19–21, 2017

Rozinov V.M., Gorbachev O.S., Fisenko M.V.

Abstract

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Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2017;7(4):113-116
pages 113-116 views

RUSSIAN-BRITISH SEMINAR OF YOUNG SCIENTISTS "BIOLOGICAL FEEDBACK IN CORRECTION OF DASFUNCTION OF THE BACK OF THE BED IN CHILDREN" Moscow, October 24-25, 2017

Guseva N.B.

Abstract

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Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2017;7(4):117-118
pages 117-118 views

Biography

К 75-летию Аитбая Ахметовича Гумерова

Abstract

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Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2017;7(4):119-120
pages 119-120 views

ПАМЯТИ ПРОФЕССОРА ВЛАДИМИРА ВЛАДИМИРОВИЧА ШАПКИНА

Abstract

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Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2017;7(4):126
pages 126 views

К 60-летию Юсуфжона Махмудовича Ахмедова

Abstract

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Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2017;7(4):121
pages 121 views

ПАМЯТИ ШАБАНОВА ВАЛЕРИЯ ЭМИНОВИЧА

Abstract

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Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2017;7(4):127-128
pages 127-128 views

К 50-летию Намира Аднановича Аль-Машата

Abstract

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Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2017;7(4):122
pages 122 views

Президиум Российской ассоциации детских хирургов и редакция журнала сердечно поздравляют с:

Abstract

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Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2017;7(4):123
pages 123 views

Reviews

PECULIAR FEATURES OF SURGERIES IN SOFT-TISSUE SARCOMAS OF THE EXTREMITIES IN CHILDREN

Tsilenko K.S., Kubirov M.S., Konovalov D.M.

Abstract

Based on the data obtained during foreign studies, the article analyses the approaches and recommendations related to the safe and necessary resection width of soft-tissue sarcomas. Currently, there are no distinct criteria that can help a surgeon to evaluate the proper volume of resected tissue in a minimum risk of a local recurrence and provide for an adequate functional result considering the subsequent reconstructive and plastic methods.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2017;7(4):81-90
pages 81-90 views

WATER-JET DISSECTION METHOD IN SURGERIES FOR SOLID TUMOURS IN CHILDREN

Rokhoev M.A., Sharoyev T.A.

Abstract

The scientifi review is devoted to the study of the water-jet dissection in oncological surgery based on the data of world literature and studies proper. The surgical dissection method in children is rather new and is relatively unknown among a wide range of readers in theRussian Federation.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2017;7(4):91-100
pages 91-100 views

TREATMENT OF INFANTS WITH NON-REFLUXING MEGAURETHER

Betanov Z.V.

Abstract

Literature review is devoted to one of the most widely spread urogenital abnormalities such as megaloureter and to modern approaches to the methods of diagnosis and treatment of the pathology in infants, in particular. Domestic and foreign scientific literature was analyzed.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2017;7(4):101-112
pages 101-112 views

TREATMENT OF INFANTS WITH NON-REFLUXING MEGAURETHER

Betanov Z.V.

Abstract

Literature review is devoted to one of the most widely spread urogenital abnormalities such as megaloureter and to modern approaches to the methods of diagnosis and treatment of the pathology in infants, in particular. Domestic and foreign scientific literature was analyzed.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2017;7(4):101-112
pages 101-112 views

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