Vol 11, No 4 (2021)

Original Study Articles

Comparative analysis of one- and two-stage urethroplasty in the treatment of proximal hypospadias in children: flap or transplant?

Surov R.V., Kagantsov I.M., Shmyrov O.S., Sizonov V.V., Volkova A.A., Zadykyan R.S., Kulaev A.V., Lazishvili M.N., Velskaya J.I.

Abstract

BACKGROUND: Surgical treatment of proximal forms of hypospadias in children is still a complex and largely unsolved problem. The large number of postoperative complications following reconstructive surgery for proximal forms of hypospadias supports scientific interest in this issue.

AIM: This study aimed to conduct a retrospective comparative analysis of the effectiveness of two types of urethroplasty. We compared fundamentally different approaches to the formation of the artificial urethra, surgical techniques that use a different type of movement, and blood supply of the plastic materials — a flap and a graft.

MATERIALS AND METHODS: The study included 113 primary patients with proximal hypospadias aged 8 months to 15 years who underwent surgery between 2013 and 2019 and were divided into two comparison groups. Group 1 included 53 (46.9%) boys; a single-stage urethroplasty was performed by the onlay-tube method, where a longitudinal skin flap of the dorsal surface of the penis was used as a plastic material. Group 2 included 60 (53.1%) patients; two-stage urethroplasty was performed by the Bracka method, where the plastic material for the formation of the artificial urethra was a preputial graft in 44 (73.3%) patients and a graft of the oral mucosa in 16 (26.7%) patients.

RESULTS: When comparing the surgical results in the form of the number of complications requiring repeated surgical interventions under anesthesia to eliminate them, corresponding to Clavien–Dindo 3B complications, a significant difference was obtained in the study groups. The surgical results were significantly better when performing the two-stage Bracka method.

CONCLUSIONS: In the surgical treatment of proximal forms of hypospadias in children, the two-stage Bracka method, where the plastic material for the formation of the artificial urethra is a preputial or mucosal graft, significantly reduced the number of postoperative complications.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2021;11(4):437-444
pages 437-444 views

Delayed surgical treatment of children with exstrophy without approximation of the pubic bones, the use of displaced flaps and immobilization of the patient

Nikolaev V.V., Demin N.V., Ladygina E.A.

Abstract

BACKGROUND: Bladder exstrophy is one of the most difficult for the reconstruction of malformations.

AIM: This study aimed to evaluate the outcomes of delayed bladder closure in exstrophy in comparison with procedures in newborns and to test the hypothesis that the reliability of bladder closure does not decrease without closing the fascial defect between the rectus abdominis muscles and that the postoperative period is more favorable.

MATERIALS AND METHODS: Delayed closure of exstrophy without osteotomy, convergence of pubic bones, or flap movement was performed in 46 patients with classic bladder exstrophy. Among them, 34 were primary patients, and the remaining patients, who had a complete relapse of exstrophy as a result of suture divergence, had undergone unsuccessful surgery in other clinics 1–4 times (n = 12). In total, 25 were boys and 21 were girls who underwent surgery from 2006 to 2021.

RESULTS: Delayed bladder closure was successful in all 46 children (100%). No signs of acute pain were noted. Serious complications such as dehiscence of the sutures in the bladder and proximal urethra were not observed. Minor complications occurred in five patients, which resolved promptly.

DISCUSSION: In the treatment of exstrophy, successful primary bladder closure is critical to achieving future urinary continence. The elimination of the defect between the rectus abdominis muscles with the convergence of the pubic bones has significant drawbacks, including an increase in the operating time and trauma, need for blood transfusion, risk of orthopedic and neurological complications, and a more difficult postoperative period. The vast majority of the patients develop rediastasis. The authors proposed a more reliable method of delayed closure of exstrophy.

CONCLUSIONS: The presented method of bladder closure was 100% successful. The procedure was simplified technically, the surgery time was reduced, and the postoperative period proceeded more easily without prolonged pain syndrome, prolonged use of analgesics, and, in most cases, without blood transfusions.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2021;11(4):445-454
pages 445-454 views

Efficiency of 3D imaging in children with abdominal echinococcosis

Minaev S.V., Gerasimenko I.N., Bykov N.I., Grigorova A.N., Timofeev S. ., Doronin F.V., Rubanova M.F., Mischvelov A.E.

Abstract

BACKGROUND: Laparoscopy in the treatment of abdominal echinococcosis is accompanied by complications. Therefore, studies on optimizing surgical approaches that reduce intra- and postoperative complications in liver echinococcosis are extremely relevant.

AIM: This study aimed to assess the possibility of using three-dimensional (3D) technologies in children with abdominal echinococcosis to determine whether it can increase the efficiency of laparoscopic treatment and reduce complications.

MATERIALS AND METHODS: A prospective analysis was conducted from 2013 to 2019 among 43 children with isolated liver echinococcosis who underwent multiport laparoscopic echinococcectomy. In the preoperative period, 25 patients from the main group used a complex of modern 3D technology: creating a 3D reconstruction of a liver with a parasitic cyst and then printing a 3D model of an organ with vessels and bile ducts.

RESULTS: The use of virtual computer visualization with the 3D reconstruction of the parasitic cyst and adjacent blood vessels with bile ducts made it possible to produce a 3D liver model. This approach provided the possibility of personalized laparoscopic access and precision in performing surgeries. Postoperatively, residual cavity (n = 1, 4.0%) was observed in the main group and biliary fistula and residual cavity (n = 2, 11.1%) in the comparison group

CONCLUSIONS: Thus, the use of 3D technologies in children with abdominal echinococcosis can increase the efficiency of laparoscopic treatment and reduce the number of early and late complications.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2021;11(4):455-462
pages 455-462 views

Vancouver Scar Scale for Assessing the Long-term Cosmetic results of surgical treatment of children with deep neck burns

Gnipov P.A., Baindurashvili A.G., Brazol M.A.

Abstract

BACKGROUND: Deep neck burns always result in cicatricial changes in the skin. Scars in this area can lead not only to functional disorders but also affect the psychoemotional status of the patient and family. Current studies have reported on the results of the treatment of deep neck burns in both adults and children. However, among foreign and Russian publications available, no studies have assessed the cosmetic results of treatment using validated scales.

AIM: This study aimed to analyze the long-term cosmetic results of surgical treatment of deep neck burns in children using the Vancouver Scar Scale.

MATERIALS AND METHODS: A non-interventional case — control study was conducted. The article analyzes the long-term cosmetic results of treatment of 64 children with deep neck burns. All patients were divided into the main group 1 — 35 (29%) children who received early surgical treatment] and control group 2 — 29 (45%) children after staged treatment]. The main group was further divided into subgroups 1a, 1b, and 1c. Subgroup 1a included 13 (20%) children who underwent tangential necrectomy with simultaneous autodermoplasty, subgroup 1b included 12 (19%) children who underwent radical necrectomy with simultaneous autodermoplasty, and subgroup 1c included 10 (16%) children who underwent necrectomy with delayed autodermoplasty. The Vancouver Scar Scale was used to assess the vascularization, pigmentation, elasticity, and size of the scar mass. For statistical analysis, the results of different options for early surgical treatment were compared with a staged method.

RESULTS: The best indicators for vascularization, elasticity, size of the formed cicatricial mass, and overall score were obtained in children who received surgical treatment of deep neck burns by early necrectomy (tangential or radical) with simultaneous autodermoplasty in comparison with staged surgical treatment. When analyzing the “pigmentation” indicator, the scores of patients who underwent all types of early surgical treatment were comparable with those in patients who received staged surgery.

CONCLUSIONS: According to the analysis of the Vancouver Scar Scale, the best cosmetic results in children with deep neck burns can be achieved by performing tangential or radical necrectomy with simultaneous autodermoplasty.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2021;11(4):475-484
pages 475-484 views

Double-barreled enterostomy with compression anastomosis in newborns and infants

Ivanov S.D., Slizovskiy G.V., Shikunova Y.V., Pogorelko V.G., Balaganskiy D.A., Yushmanova A.B., Gunther V.E., Khodorenko V.N., Anikeev S.G.

Abstract

BACKGROUND: Staged treatment of small bowel diseases involves the formation of an enterostomy. Bishop–Koop T-anastomosis and Mikulicz double-barreled enterostomy with compression clamp are widely applied. The disadvantages of Mikulicz’s can be eliminated using a clip of titanium nickelide with shape memory instead of a clamp.

AIM: This study aimed to evaluate the efficacy and safety of a titanium nickelide device in double-barreled enterostomy and compare the results of treatment with a T-anastomosis.

MATERIALS AND METHODS: The study included newborns and infants. The clip was applied on 9–58 days postoperatively. Differences were accepted as significant at p < 0.05.

RESULTS: Since 2000, enterostomy was performed in 79 children: 12 (15.2%) had T-anastomoses, 44 (55.7%) had double-barreled stomas, and 18 (40.9%) had a titanium nickelide clip. In the study groups, stomas were applied for ileus, atresia, and aganglionosis. In the group of double-barreled enterostomies with a clip, the stoma was closed later (p = 0.027) and the operation time was short (p = 0.013). In the T-anastomosis group, parenteral nutrition was required for a longer period (p = 0.018). Self-removal of the clip and appearance of the stool occurred on days 5 and 1–3. Compression anastomosis was obtained in 83.3% and stoma closure outside in 73.3%. With a double-barreled enterostomy, hepatic failure (p = 0.018) and anastomosis dysfunction (p = 0.046) were less common. T-anastomosis revealed an increase in the incidence of CDC II (p = 0.013) and III (p = 0.015) complications.

DISCUSSION: The results reflect the safety of the presented method in comparison with the T-anastomosis, since the operation time and duration of the parenteral nutrition are reduced, invasive treatment is less often required for complications, and anastomosis dysfunction rarely occurs.

CONCLUSIONS: Double-barreled enterostomy with a compression clip is an effective and safe alternative to T-anastomosis in children aged <1 year. The formed compression anastomosis allows closure of the stoma by suturing its outer part. The conditions for the formation of the anastomosis are the patency of the distal sections and bowel diameter ≥1 cm.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2021;11(4):463-474
pages 463-474 views

Superimposed high-frequency jet ventilation in children with oncohematological diseases and acute respiratory distress syndrome

Ivanashkin A.Y., Novichkova G.A., Lazarev V.V., Khamin I.G., Tsypin L.E., Spiridonova E.A., Maschan A.A.

Abstract

BACKGROUND: The mortality rate of children with hematological cancer and acute respiratory distress syndrome is still high, which is often associated with the ineffectiveness of traditional mechanical ventilation methods in the treatment of critical hypoxemia in these patients. Currently, the search continues for alternative methods of respiratory support, one of which is the combined high-frequency jet artificial ventilation of the lungs.

AIM: This study aimed to evaluate the efficacy and safety of combined high-frequency jet artificial ventilation in the treatment of children with hematological malignancies and severe acute respiratory distress syndrome.

MATERIALS AND METHODS: The study was conducted in the Department of Resuscitation and Intensive Care of the Dmitry Rogachev National Medical Research Center for Pediatric Hematology, Oncology and Immunology, from 2016 to 2020. Combined high-frequency jet artificial ventilation was used as an alternative method of respiratory support.

RESULTS: In case of severe hypoxemia caused by secondary severe acute respiratory distress syndrome, the use of combined high-frequency jet ventilation after 12 h leads to a significant improvement in arterial blood oxygenation, improves the biomechanical characteristics of the respiratory system, and reduces the likelihood of developing ventilator-associated lung damage. An increase in oxygenation and absence of an effect on the indicators of central hemodynamics provide a greater delivery of oxygen to the tissues, thereby improving the general condition of the patients.

CONCLUSIONS: In severe parenchymal respiratory failure accompanied by critical hypoxemia, combined high-frequency jet artificial ventilation of the lungs can be considered an alternative method of respiratory support.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2021;11(4):485-500
pages 485-500 views

Comparative assessment of acceptability of the prognostic scales in predicting the risk of interhospital evacuation of newborns

Mukhametshin R.F., Davidova N.S.

Abstract

BACKGROUND: The safety of interhospital transfer of newborns remains one of the most important issues of emergency neonatology. Assessment of risks associated with transfer is the basic concern of pre-transport preparation.

AIM: This study aimed to assess and compare the predictive value of the KSCHONN, National Therapeutic Intervention Scoring System (NTISS), and TRIPS scales in predicting the risks associated with the interhospital transfer of newborns.

MATERIALS AND METHODS: The cohort study included data from 604 visits of the transport team. The KSHONN, NTISS, and TRIPS scales were used in the assessments, the therapeutic actions of the transport team during transfer were evaluated, and mortality during the first day after assessments was analyzed. The area under the receiver operating characteristic curve (AUC ROC) was calculated for the KSCHONN, NTISS, and TRIPS scales in relation to the therapeutic actions of the transport team and first-day mortality.

RESULTS: The predictive values of the KSHONN and TRIPS scales for additional infusion reflected AUC ROC values of 0.877 (0.436–1.317) and AUC ROC 0.889 (0.468–1.311), respectively. The AUC ROC value for predicting catecholamine dose adjustment or appointment and correction of ventilation for all three scales was less than 0.8. The predictive value of all three scales in the prediction of death on the day after the assessment of the transport team is high, and the TRIPS scale had the highest AUC ROC [0.988 (0.977–0.999)], which was significantly higher than that for the NTISS scale 0.875 (0.790–0.959) (p = 0.004). The KSHONN scale demonstrated a better predictive value for daily mortality [0.984 (0.861–1.003)] in comparison with NTISS (p = 0.001). The risk ratio of the daily mortality in the group of patients with an assessment of 9–4 points according to KSHONN in comparison with patients with an assessment of 6–8 points was 17.73 (0.88–355.8).

CONCLUSIONS: The evaluated scales predict patient death within a day after the assessment of the transport team with good accuracy, and the KSHONN and TRIPS scales predict the need for additional infusion during transfer. However, none of the scales predict other actions of the team associated with the deterioration of the patient’s condition during transfer with the required accuracy.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2021;11(4):501-510
pages 501-510 views

Case reports

Treatment of a newborn with birth trauma of the liver with catheter embolization of a vessel

Yanitskaya M.Y., Shestakova E.V., Ivanenko A.N.

Abstract

Birth trauma of the liver with the development of subcapsular hematoma and hemoperitoneum is reported extremely rarely. The slow enlargement of the hematoma also results in delayed development of bleeding symptoms. Noticeable clinical manifestations appear simultaneously when the hematoma ruptures into the abdominal cavity. Later, the symptoms develop very quickly that doctors failed to understand the root cause of the bleeding. The diagnosis is established only during autopsy. When conservative therapy is ineffective, open surgery is conducted; however, the surgery is associated with a high risk of unfavorable outcomes. Herein, we present a clinical case demonstrating successful treatment with endovascular embolization of a vessel due to bleeding from a giant subcapsular hematoma of the liver in a newborn.

The child was born in a settlement of the Arkhangelsk Region and weighed 3480 grams. A vacuum extractor was used to assist the weak mother during delivery. The child was in a critical condition and suffered from asphyxia. Mechanical ventilation was used. At 10 h after birth, the child was taken to a specialized neonatal center of Arkhangelsk (the helicopter flight took 2.5 h). The intensive therapy continued. Negative dynamics followed. At 25 h after birth, hemodynamic indexes decreased. X-ray and ultrasound investigations of the abdominal cavity revealed a large hematoma in the liver. It occupied the entire area of the right liver lobe. Abdominal bleeding was diagnosed. The child was taken to the X-ray department. The newborn underwent urgent endovascular embolization of the right hepatic artery. The bleeding was stopped, and the child’s condition was stable. On follow-up at age 1 year and 5 months, the child’s development was in accordance with age, and blood biochemical parameters were within normal limits. Ultrasound data revealed well recovery of the liver structure.

With extensive birth trauma of the liver, minimally invasive surgery, i.e., endovascular embolization of vessels, can be considered an alternative option to surgical treatment.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2021;11(4):511-518
pages 511-518 views

Postoperative complications of laparoscopic cholecystectomy in children: two cases report

Karpova I.Y., Strizhenok D.S., Egorskaya L.E., Parshikov V.V., Egorskaya A.T.

Abstract

Only a few studies have investigated the complications of laparoscopic cholecystectomy in children. Therefore, relevant case reports will be of interest to pediatric surgeons.

The patient was a 10-month-old boy diagnosed with calculous cholecystitis who underwent laparoscopic cholecystectomy. He had peripheral edema and adhesions in the neck of the gallbladder. After 10 h, a clinical picture of intra-abdominal bleeding developed. During relaparoscopy in the area of the gallbladder bed, arterial bleeding from the liver vessel was noted, which was eliminated by coagulation. The postoperative period was uneventful, and the child was discharged on day 8. In the second case, a 10-year-old girl was admitted for chronic calculous cholecystitis, and laparoscopic cholecystectomy was performed, in which a pronounced adhesion process was noted in the gallbladder neck region. On day 8, the child was discharged home; however, after 26 days, the patient was admitted again, with a clinical picture of diffuse biliary peritonitis. During laparoscopy, bile outflow from the gallbladder bed was noted, which only partially eliminated by monopolar electrocoagulation. Drainages were installed, through which bile began to be abundantly secreted in the postoperative period. Laparoscopy with a transition to open surgery was performed, during which a perforation in the wall of the common bile duct was found, and stenting and suturing of the defect were performed. In the postoperative period, active infusional infusion and antibacterial therapy were given. The patient was discharged on day 29.

Postoperative complications of the Clavien–Dindo type IIIb are associated both with the presence of congenital anatomical features and inflammatory-adhesive changes in the Calo triangle zone and with the possibility of latent lesions during monopolar coagulation in both cases. The evaluation of the tactics of eliminating biliary peritonitis in the second patient emphasized the necessity to switch to open laparotomy during the second operation.

These cases indicate the need to comply with the principles of safe laparoscopic cholecystectomy, including the availability of modern endoscopic equipment and the experience of surgeons in endosurgery. This requires the concentration of patients with cholelithiasis in specialized clinics.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2021;11(4):519-528
pages 519-528 views

Treatment of a 5-year-old child with damage to the esophagus: a case report

Belov S.A., Cyleva Y.I., Grigoryuk A.A.

Abstract

Diagnosis and treatment of esophageal injuries remain the most difficult problems in pediatric urgent surgery with high mortality rates. Restoration of function in severe multiple-organ disorders associated with the development of mediastinitis and sepsis in children requires a multidisciplinary approach and the search for alternative treatment methods that help close the esophageal defect and prevent inflammation. These methods include a constant negative pressure system.

Severe polytrauma led to the development of local inflammation and mediastinitis. The formed esophageal fistula with clinical sepsis required multistage surgical treatment and support of several specialists. At the Regional Children’s Clinical Hospital No. 1 in Vladivostok, at the first stage of treatment, the mediastinum and soft tissues of the neck were drained, which made it possible to stop the spread of inflammation and stabilize the patient’s condition. The effectiveness of the second stage of surgical treatment using the VAC system was noted in the first 48 h, in the form of a significant reduction in local inflammation and elimination of skin maceration. The VAC system provided adequate drainage of the wound cavity and promoted wound cleansing and growth of granulation tissue. Dissociation of the fistula by applying a gastrostomy made it possible to create favorable conditions for the healing of the esophageal defect and ensure adequate enteral nutrition for the patient.

Damage to the esophagus with the development of mediastinitis and sepsis are critical conditions; therefore, treatment outcomes depend on early diagnosis and timely surgical treatment. A full-fledged surgical treatment in a specialized hospital helps eliminate complications of damage to effectively restore functions and lead to patient recovery.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2021;11(4):529-536
pages 529-536 views

Reviews

Current understanding of the treatment of newborns with intestinal malrotation: a systematic review

Trofimov V.V., Mokrushina O.G.

Abstract

This review aimed to analyze and organize information on the treatment of newborns with bowel malrotation. A systematic review was conducted using the databases PubMed, Web of Science, Google Scholar, Scopus, and eLibrary and journals of Pediatric Surgery, Russian Bulletin of Pediatric Surgery, Anesthesiology and Reanimatology, and Pediatric Surgery from 2010 to 2020. The search terms were as follows: malrotation, neonatal, infant, newborn, intestinal malrotation, malrotation, neonatal period, Ledd’s syndrome, and midgut volvulus. All journal issues were reviewed for the selected period.

Following the screening of published articles, six full-text articles that met the selection criteria were included in the systematic review. A total of 191 patients with bowel malrotation that received various treatments were described: 98 patients underwent defect correction by laparoscopy and 93 patients underwent laparotomy. Bloating was found in 103 children. Reoperations were performed on 18 newborns because of relapse. Complications in the postoperative period were noted in 25 cases, and treatment of 16 children was fatal. No study was performed following a high methodological level.

To date, studies on the surgical treatment of newborns with bowel malrotations are limited. In addition, none of the studies were conducted at a high methodological level. The lack of randomized controlled trials can be compensated for by closer collaboration between medical clinics, collection of a larger evidence base based on the analysis of the results of cohort and case–control studies, and examination of the reasons for the variability of results among centers.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2021;11(4):537-544
pages 537-544 views

Historical Articles

About those who are in memory

Geldt V.G.

Abstract

The article is devoted to the period of the author’s work in three leading teams of pediatric surgeons in Russia: 1) Department of Pediatric Surgery of the Leningrad Pediatric Medical Institute under the leadership of the Corresponding Member of the Russian Academy of Medical Sciences Professor G.A. Bairov. This part described the role of the student scientific circle in the upbringing and development of future pediatric surgeons and the merits and personal qualities of G.A. Bairov. 2) Department of Pediatric Surgery of the Central Order of Lenin of the Institute for Advanced Training of Doctors, which played a leading role in the professional training and improvement of surgeons who were involved in the treatment of children. This part presents the main forms of work with cadets and requirements for the teaching staff. Much attention is paid to the merits of the Head of the Department Academician of the Russian Academy of Medical Sciences S.Ya. Doletsky and his role in the development of pediatric surgery. 3) Department of Urology and Neuro-urology of the Moscow Research Institute of Pediatrics and Pediatric Surgery under the guidance of Prof. E.L. Vishnevsky, who made great contributions to pediatric urology and created a virtually new section of the specialty — pediatric neuro-urology..

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2021;11(4):545-552
pages 545-552 views

Commentary on the article by V.G. Geldt “About those who are in memory”

Petlakh V.I.

Abstract

The commentary to the article characterizes Vadim G. Geldt in the field of pediatric surgery, which the author modestly kept silent about in his article.м

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2021;11(4):553-554
pages 553-554 views

Lectures

Glutamine solution in the parenteral nutrition for children with critical conditions

Erpuleva Y.V.

Abstract

Nutritional support for children with critical conditions is currently considered as the most important factor in the complex of therapy, which can prevent catabolism and risk of postoperative complications. Underestimation of the nutritional factor can lead to poor outcomes, such as a decrease in immunological resistance and the occurrence of postoperative complications.

Acute trauma in critically ill patients is characterized by metabolic and systemic responses, including an immune-inflammatory response that leads to immunosuppression and nosocomial infections. Parenteral nutrition is prescribed for patients in the intensive care unit who cannot be fed naturally to provide protein and energy substrates because of impaired homeostasis. The active use of arginine, glutamine, and omega-3 fatty acids is mainly indicated for patients with injuries and burns. Moreover, the discussion about the use of immune nutrition (arginine, glutamine, and omega-3 fatty acids) continues given the need for active use in intensive care. The article provides a review of the literature on the use of glutamine solution in parenteral nutrition for children. The article discusses modern approaches to prescribing parenteral nutrition with the additional use of glutamine solution, which has beneficial effects on the child’s body — increases the absorption function of the intestine, increases the thickness of the intestinal mucosa, helps maintain the morphological integrity of the intestine, and reduces intestinal permeability. Recent meta-analyses have shown the effect of glutamine-rich diets especially in patients with critical conditions. The addition of glutamine improves cellular processes and functioning of organs and systems. This leads to an improvement in immune competence, barrier function, and cessation of the inflammatory process. It is also a substrate for the formation of nitrite oxide and improves the formation of adenosine triphosphate in cells. Glutamine is an energy substrate for proliferative cells, including lymphocytes. In general, glutamine has a positive effect on many organs and systems, including the gastrointestinal systems, kidneys, lungs, heart, and liver. Immune nutrition has an anti-inflammatory effect, which helps prevent the development of acute phase response. In addition, it restores the indicators of protein metabolism in the early stages of parenteral nutrition. Therefore, the use of glutamine solution in total or complementary parenteral nutrition programs can optimize the quality of treatment for children.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2021;11(4):555-560
pages 555-560 views

News

Results of the VII Forum of pediatric surgeons of Russia

Rozinov V.M., Suvorov S.G., Petlakh V.I., Gorbachev O.S., Erokhina N.O.

Abstract

The VII Forum of Russian Pediatric Surgeons was held in a hybrid format on October 21–23, 2021, in Moscow in the auditoriums of two children’s hospitals. The program of the plenary session of the forum included the presentation of the annual award S.D. Ternovsky “For a Great Contribution to the Development of Domestic Pediatric Surgery,” which was awarded to Professor V.G. Geldt. Within the framework of the forum, a symposium “Organization of pediatric surgical care in Russia” and a working meeting of the Russian Association of Pediatric Surgeons were held, at which the status of pediatric surgery as a specialty was discussed, and reports of members of the Presidium of the Russian Academy of Arts on the activities in 2019–2021 were heard. The video session “How I Do It” aroused the genuine interest of all participants both directly in the audience and online (1,045 people). A total of 1568 specialists from 15 countries took part in the forum. Within 4 days of the forum, 138 speakers presented 154 reports. On the final day of the forum, a traditional competition for research works by young scientists took place.

The Forum of Russian Pediatric Surgeons contributes to the broad promotion of innovative ideas and technologies and the integration of domestic specialists into the international professional space. All forum reports are available on the Internet.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2021;11(4):561-570
pages 561-570 views

All-Russian Student Forum “Minimally invasive technologies in pediatric surgery. From theory to practice” dedicated to the memory of Professor A.V. Geraskin

Al-Masaht N.A., Erokhina N.O., Shumikhin V.S.

Abstract

The Training Center for Innovative Medical Technologies was opened at the Pirogov Russian National Research Medical University in 2011 with the active participation of Professor A.V. Geraskin. On the following year, the All-Russian Student Forum “Minimally Invasive Technologies in Pediatric Surgery” was conducted. If eight teams from six universities took part in the first forum, there were 30 teams from 16 universities in Russia in the tenth anniversary forum in 2021. The forum held intellectual and practical competitions, which included performing tasks on simulators in a simulation operating room. Forum participants become successful pediatric surgeons, who are continuers of the traditions of our profession.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2021;11(4):571-576
pages 571-576 views

Biography

To the 75th anniversary of Azamat M. Shamsiev

Gorbachev O.S.

Abstract

The paper describes the professional activities and merits of the pediatric surgeon Azamat M. Shamsiev, in celebration of his anniversary.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2021;11(4):577-578
pages 577-578 views

In memory of Bela M. Lolaeva

Dzheliev I.S.

Abstract

The paper provides information about the sudden death of pediatric surgeon Bela M. Lolaeva.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2021;11(4):581-582
pages 581-582 views

To the 60th anniversary of Dmitry Yu. Vybornov

Lozovaya Y.I.

Abstract

The paper describes the professional activities and merits of the pediatric surgeon Dmitry Yu. Vybornov, in celebration of his anniversary.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2021;11(4):579-580
pages 579-580 views

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