Vol 8, No 1 (2018)

Cover Page

Full Issue

Case reports

INTESTINAL OBSTRUCTION DUE TO GASTRO-INTESTINAL DIOSPYROBEZOARS IN CHILDREN

Okunev N.A., Okuneva A.I., Pervova N.A., Shilov A.A.

Abstract

The article describes two observations of acquired mechanical intestinal obstruction in children that occurred due to diospyrobezoars (phytobezoars formed in a persimmon). In the first case the obstruction was removed endoscopically. Thus, the major part of the diospyrobezoar was removed from the stomach using fibrogastroscopy whereas small fragments left the stomach spontaneously. In the second case diagnostic laparoscopy failed to reveal the reason for intestinal obstruction. Conversion was done; a foreign body was found in the jejunal lumen in the course of intestinal revision. The body was smashed palpatory and moved into the large intestine. The presented observations show that it is possible to apply the methods of removal of intestinal obstruction due to diospyrobezoars without dissecting the lumen of a hollow organ.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2018;8(1):62-65
pages 62-65 views

EXPERIENCE WITH TREATMENT OF A NEWBORN WITH CHYLOPERITONEUM

Sudakova N.M., Osmanov I.M., Ostreykov I.F., Maykova I.D., Podkopaev V.N., Lagoshin G.N., Dovnar Y.N., Sokolov Y.Y.

Abstract

The article describes a clinical case of treatment of a newborn with chyloperitoneum against the background of a severe concurrent pathology of the bronchopulmonary system. Chylous effusion was useful during a surgery. In the conservative therapy they used parenteral feeding, octreotide and artificial pulmonary ventilation. The complete parenteral feeding was given for 8 days. The total use of APV considering the concurrent pathology accounted for 86 days. The child was shifted to the second stage of care and discharged when he was 4 months old.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2018;8(1):66-70
pages 66-70 views

CAVERNOUS HAEMANGIOMA OF THE SPLEEN IN THE CHILD

Zhurilo I.P., Medvedev A.I., Chernogorov O.L., Petrova O.V., Timoshina O.A., Alekseev A.G.

Abstract

The clinical picture, diagnosis and surgical treatment of a child with cavernous hemangioma of the spleen are described.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2018;8(1):71-74
pages 71-74 views

ATYPICAL MANIFESTATION OF THE PROPOFOL INFUSION SYNDROME IN A 6-MONTH-OLD CHILD

Lazarev V.V., Bystrova A.A., Bryusov G.P., Tsypin L.E., Popova T.G.

Abstract

The authors present the case of the propofol infusion syndrome (PrIS) in a 6-month-old. The first symptoms were represented by the unexplained central nervous system disturbances such as sopor that remained during 3 days after the agent was discontinued.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2018;8(1):75-79
pages 75-79 views

Historical Articles

140 YEARS OF NOBLE SERVICE (St. Vladimir Children’s Hospital: 1876–2016)

Kireeva N.G., Leonovich V.P., Popov V.V.

Abstract

St. Vladimir Children’s Municipal Hospital celebrated its 140th anniversary in 2016. The article is devoted both to the history of the hospital and development of domestic pediatric surgery on the hospital territory. In the next issues the editorial staff of the magazine is planning to expand on the scientific and clinical activity of the pediatric surgery department of the hospital-based Central Physicians’ Continuing Education Institute.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2018;8(1):105-112
pages 105-112 views

Original Study Articles

DIAGNOSTICS AND TREATMENT OF HIRSCHSPRUNG’S DISEASE IN CHILDREN FROM THE RUSSIAN FEDERATION (PREPARAING THE PROJECT OF THE FEDERAL CLINICAL RECOMMENDATIONS)

Morozov D.A., Pimenova E.S.

Abstract

The article contains the data related to the creation of the Project of Federal Clinical Recommendations on how to treat children with Hirschsprung’s disease applicable in the Russian Federation. The Project has been prepared for three years and consisted of several stages such as questioning of pediatric surgeons and the leading pediatric coloproctologists from Russia and neighboring countries (analyzing two questionnaires of 2015 and 2016), analysis of domestic and foreign literature depending on the topic, reporting the first results of the study during the XVII European Congress of pediatric surgeons, scientific discussion of specialists with a wide experience in treatment of patient with Hirschsprung’s disease in a profile academic periodical within two years.

During the study it was found out that they used different methods in diagnostics, treatment and postoperative rehabilitation of Hirschsprung’s disease and some issues are discordant.

The Project of Federal Clinical Recommendations made on the basis of the conducted work will be discussed at the All-Russia Symposium of Pediatric Surgeons with international participation ‘Hirschsprung’s disease and neurointestinal dysplasia in children’ in April 2018 and publicly available on the website of the Russian Association of Pediatric Surgeons. 

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2018;8(1):6-12
pages 6-12 views

COMPARATIVE EVALUATION OF CLINICAL EFFECTIVENESS OF THE INFUSION THERAPY WITH BALANCED AND UNBALANCED SOLUTIONS IN SEPSIS IN CHILDREN

Mironov P.I.

Abstract

The purpose of the study was to provide for comparative evaluation of clinical effectiveness of volemic reimbursement in children suffering from sepsis when using balanced and unbalanced infusion media.

Methods. This was a prospective, observational, controlled and single center study. 35 children were included into the development. Depending on the use of basic infusion medium, the children were divided into two groups such as the control group (n=20) with Ringer’s solution and the basic group (n=15) with Sterofunding Isotonic. The tactics of initial infusion therapy and intensive therapy of sepsis was comparable between the two groups. The clinical effectiveness was evaluated based on estimation dynamics using the PELOD scale, inotropic support duration, therapy duration, lethality, and monitoring of physiological variables.

Results. In 24 hours of intensive therapy, PELOD- estimated severity of patients’ conditions is comparable between the groups. Children of the basic group had less frequent signs of acute renal failure, decreased duration of inotropic support and reduced hospital treatment duration.

Conclusion. The use of balanced solutions applied during the infusion therapy of children suffering from sepsis is not associated with the variations in lethality and ALV duration. However, it can reduce the frequency of acute renal failures and inotropic support duration. 

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2018;8(1):44-48
pages 44-48 views

EPIDEMIOLOGY OF ACUTE INTOXICATION IN CHILDREN FROM THE TOMSK REGION

Bocharov R.V., Varlamov K.G., Andreev A.N., Shchegolev V.E., Gaifullin R.R., Munkin V.A., Semchenko E.A.

Abstract

The structure of chemical intoxication in children from the city of Tomsk in the last five years has been analyzed. The average age was 7.4 ± 0.34 years old. The increased frequency of cases was associated with the following ages: 1 to 3 years old and 7 to 16 years old. There were more boys as compared to girls: 58.4 and 41.6 %, respectively. The average time of poison exposure was 4.8 ± 0.6 hours. Enteral intoxication predominated over inhalation (10.7 %), nasal (2.7 %) and parenteral (1.7 %) intoxication. The medicinal agents (49.6 %) associated with negligent storage and failure to comply with the dosage regimen occupied the leading role in the intoxication structure.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2018;8(1):57-61
pages 57-61 views

SURGICAL CORRECTION OF THE HIGH UROGENITAL SINUS IN GIRLS WITH CONGENITAL ADRENAL HYPERPLASIA USING THE ANTERIOR SAGITTAL TRANSANORECTAL APPROACH

Kagantsov I.M., Shiryaev N.D., de Castro R.

Abstract

Surgical correction of the high urogenital sinus (UGS) is still a complex task. The use of complete urogenital mobilization or mobilization using a single block in the high UGS is inconsistent. We prefer to separate the vagina from the UGS with its subsequent bringing down to the perineum. The anterior sagittal transrectal approach ensures an optimal review of the uretrovaginal fusion and promotes the vaginal displacement and its separation from the urethra in these cases. The method generates an increasing interest. Thus, we describe the procedure and announce the initial results of its usage in the treatment of children with the high UGS.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2018;8(1):13-22
pages 13-22 views

ROENTGENO-ANATOMIC STRUCTURE OF URETERS WITH VARIOUS CONTRACTILE ACTIVITY IN CONGENITAL NON-REFLUXING MEGAURETER IN CHILDREN

Deryugina L.A., Krasnova E.I., Goremykin I.V.

Abstract

Purpose: to study roentgeno-anatomic peculiarities of ureters with various contractile activity in congenital non-refluxing megaureter in children.

Materials and methods: 47 children with congenital non-refluxing megaureter aged 3 months to 11 years underwent a complex urologic examination and X-ray ureteropyelometry with diuretic stimulation.

According to the study results, the patients were divided into 2 groups: those having a low contractile activity of the ureter (12 patients, the average frequency of ureter contractions of 0–3.6 per minute) and those with a normal contractile activity of the ureter (35 patients, average frequency of ureter contractions of 4–7.6 per minute).

The authors suggested such an integrated value as the ‘ureteral index’. It displayed roentgen and anatomic peculiarities of ureters with various contractile functions. The differences between the groups by the ureteral index are significant (p=0.000001).

Results and conclusions: the ureteral index over 0.19 with 87.5% sensitivity and 92% effectiveness characterize ureters with a low contractile function

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2018;8(1):23-30
pages 23-30 views

RESULTS OF CONGENITAL HYDRONEPHROSIS SURGICAL CORRECTION IN INFANTS

Beknazarov D.B., Agzamkhodjaev S.T., Abdullaev Z.B., Sanginov S.A.

Abstract

131 children with congenital hydronephrosis (CH) underwent a surgery. The patients were divided into 2 groups: group I (n=91) with children from 1 month old to 1 year old, and group II (n=91) with children from 1 to 3 years old. Analysis of surgical treatment results has shown that the frequency of intra- and postoperation complications in the both groups was the same. Good and satisfactory results were noted in 89 (98%) patients from group I and in 38 (95%) patients from group II. This reveals a high effectiveness of surgical treatment and feasibility of early correction of the defect. The conducted studies show that the long-term follow-up of children with congenital hydronephrosis is insufficient.

Early correction of pyeloureteral segment obstruction (PSO) in the lack of infection allows to preserve the renal function and creates optimal conditions for subsequent development and growth of renal tissue functional structures. 

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2018;8(1):31-35
pages 31-35 views

SURGICAL TREATMENT OF VASORENAL HYPERTENSION IN CHILDREN

Razumovsky A.Y., Alkhasov A.B., Bataev S.M., Abdurazakov M.A.

Abstract

Purpose. To estimate the results of surgical treatment of children with vasorenal hypertension.

Materials and methods. 11 patients with renovascular hypertension were operated from 1999 to 2015 with 9 boys and 2 girls among them. Their age varied from 5 months to 14 years old. Their weight was 4.6 kg to 40 kg. All children had high blood pressure values (130/80 to 250/120 mmHg) in spite of antihypertension drug therapy given.

Results. 10 patients had plasty of renal arteries affected both unilaterally (6) and bilaterally (4). An internal iliac artery was taken as a transplant in 10 cases whereas the great saphenous iliac vein was used in 2 cases. 1 child had undergone reimplantation of the renal artery. One patient in the group had the middle aortic syndrome (MAS) and pronounced hyperplasia of the renal arteries. Only abdominal aortic repair was performed in this case. In all cases a positive result was noted in the form of normalization of arterial blood pressure values until the complete withdrawal of antihypertensive agents (in 7 cases) or significant dosage reduction (4 patients).

Conclusions. Surgery is the basic method in the treatment of children with renovascular hypertension. Using the internal ileac artery as a transplant is accompanied with good early and remote postoperation results. The internal ileac artery and great saphenous vein can be used in a bilateral lesion. 

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2018;8(1):36-43
pages 36-43 views

Lectures

PARENTERAL NUTRITION IN CHILDREN

Erpuleva Y.V.

Abstract

A lecture for practitioners who come across the issues of parenteral nutrition in children is presented below. The basic indications for parenteral nutrition given to children are considered in the lecture. The necessity of prescribing all parenteral nutritional components such as proteins, fats, carbohydrates, vitamins and microelements is determined.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2018;8(1):49-56
pages 49-56 views

News

TREATMENT OF INJURIES OF THE MUSCULOSKELETAL SYSTEM IN CHILDREN (Based on the materials of the III All-Russian Congress “Medical care for injuries in peacetime and wartime. New in organization and technology”, 16–17 February 2018, St. Petersburg)

Petlakh V.I.

Abstract

The paper provides an overview of the reports at the surgical forum devoted to the problems of traumatological care for children. The information is of interest to pediatric surgeons, traumatologists and other pediatric specialists.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2018;8(1):113-118
pages 113-118 views

ANNOUNCEMENT OF SCIENTIFIC EVENTS

Editorial A.

Abstract

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Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2018;8(1):119-120
pages 119-120 views

Biography

ANNIVERSARIES

Editorial A.

Abstract

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Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2018;8(1):121-127
pages 121-127 views

Reviews

INCARCERATED INGUINAL HERNIAS IN CHILDREN

Kozlov Y.A., Novozhilov V.A., Baradieva P.Z., Zvonkov D.A., Ochirov C.B.

Abstract

The issue of surgical treatment of children with incarcerated inguinal hernias is presented. The evolution of views on the incarceration pathogenesis in the presence of a non-obliterated Nuck’s diverticulum with subsequent ischemia and threatening necrosis of internal organs in the hernia sac is reviewed. Authors who are in favor of early correction of inguinal hernias in young children present their arguments. Techniques of the strategy that allows for preliminary conservative invagination and subsequent delayed surgical reconstruction are presented. Detailed advantages of endosurgical interventions and possible complications in the treatment of children with incarcerated inguinal hernias including the reasons for blood flow reduction in the testes following hernioherniorrhaphy are presented.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2018;8(1):80-95
pages 80-95 views

ONE-LUNG VENTILATION DURING CHEST OPERATIONS IN CHILDREN WITH ONCOLOGICAL DISEASES

Martynov L.A., Matinyan N.V., Sotnikov A.V.

Abstract

Treatment of children with mediastinal and pulmonary tumors is a pressing issue both in surgery and in anesthesiology. Currently, a growing number of the tumors can be removed with video-assisted thoracoscopic surgery (VATS) due to the development and introduction of modern technologies.

From the anesthetic management point of view, the issues of providing optimal conditions for a surgery such as complete collapse of the lung on the operated part in adequate oxygenation and effective transport of oxygen to the tissues and protection of the contralateral lung from the blood and tumour detritis are brought to the forefront.

Adequate anesthetic management in thoracic oncological surgery is a very important factor which determines a patient’s safety increasing treatment quality and reducing the duration of hospitalization. 

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2018;8(1):96-104
pages 96-104 views

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