Vol 6, No 3 (2016)

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Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016;6(3):7-7
pages 7-7 views

Editorials

PEDIATRIC SURGERY IN RUSSIA - PRELIMINARY RESULTS OF OPRTIMIZATION

Rosinov V.M., Vaganov N.N., Gorbagyov O.S.

Abstract

The results of monitoring of provision of Russian children with surgical specialists and specific beds in 2010-2015 in accordance with the period of healthcare reforms referred to as optimization are submitted. Tendencies in the country, federal districts and constituent units of the Russian Federation are stated. It is indicated that reduction in the number of specialists and surgical beds carried out without proper scientific substantiation doesn’t only contain risks of decreased availability of specialized medical aid rendered to children but also fails to correspond to the concept of national safety. The necessity of development of regulatory framework regulating territorial planning of the system of medical aid to children depending on geographical, demographic, transport and infrastructure peculiarities of the regions is substantiated.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016;6(3):8-18
pages 8-18 views

Case reports

A CASE OF LAPAROSCOPIC CORRECTION OF A DIAPHRAGMATIC HERNIA IN A 5-YEAR-OLD CHILD

Parshikov V.V., Karpova I.Y., Obryadov V.P., Rozhdenkin E.A.

Abstract

Congenital diaphragmatic hernia (CDH) is a severe pathology connected with the defect in diaphragm development. It occurs in 1 case per 2000 to 4000 of newborns. Hernias of the esophageal opening, diaphragmatic cupula and retrosternal area are found in elder children. David C. Van der Zee and Klass (N.) M.A. Bax were the first to offer the endosurgical method of diaphragmatic hernia correction using laparoscopic approach. The presented case of laparoscopic correction of diaphragmatic hernia in a 5-years-old kid shows the experience of surgery of this pathology using ENDO STITCH,10 mm (USA, 2004).
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016;6(3):81-84
pages 81-84 views

Original Study Articles

NECROTIZING ENTEROCOLITIS OF NEWBORNS - PRESSING ISSUES AND FACTORS PROGNOSTICATING TREATMENT OUTCOME

Svirsky A.A., Sevkovsky I.A., Averin V.I., Marakhovsky K.Y., Makhlin A.M., Valek L.V., Silina E.V., Anisimova E.V., Ustinovich E.V., Poleschuk V.Y., Kachan A.A.

Abstract

The article presents the results of retrospective analysis of treatment of 71 newborns with necrotizing enterocolitis admitted to the Centre of Pediatric Surgery from 2007 to 2015. Peculiarities related to the course of pregnancy, labor, volume and quality of rendered aid at labor, duration of newborns’ stay at the resuscitation departments, treatment type, time of beginning and method of enteral feeding raising, clinical and laboratory data of initial manifestations and signs of necrotizing enterocolitis at the stages of rendering specialized aid before admittance to the hospital. Data are analyzed using https:// medcalc.net/stats/ online program. The most significant factors influencing the outcome of NEC in mature and premature patients considering the body mass at birth and gestational age are established. Groups of risk among pregnant women and premature newborns are revealed. It is established that the most significant factors influencing the outcome of NEC in premature and mature children are represented by the body mass at birth and gestational age.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016;6(3):19-26
pages 19-26 views

PERIODIC DISEASE AS «THE MASK OF THE ACUTE ABDOMEN» AND CAUSE "IN VAIN" SURGERY IN CHILDREN

Dyakonova E.U., Valieva S.I., Alekseeva E.I., Bzarova T.M., Sleptsova T.V., Bekin A.S., Romanova E.A.

Abstract

Actuality: The complexity of the diagnosis of abdominal forms of periodic disease often leads to unnecessary surgical intervention. Objective: To evaluate the characteristics of the course of periodic disease in children, and to develop patient management algorithm during an exacerbation. Materials and Methods: The presented analysis of treatment of 18 patients with Barrett’s esophagus. We describe the medical history, the clinical picture of the disease, laboratory and instrumental examination of patients, including genetic testing; and also carried out a detailed differential diagnosis with other acute surgical diseases. Conclusions: Adherence to the algorithm of diagnosis of periodic disease to avoid unjustified surgical interventions
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016;6(3):67-72
pages 67-72 views

OUR EXPERIENCE IN TREATMENT OF SUPERSHORT FORM OF HIRSCHPRUNG DISEASE IN CHILDREN

Svarich V.G., Kirgizov I.V.

Abstract

In the period from 1991 to 2015 years under our supervision were 203 patients with ultrashort form of Hirschsprung’s disease. All patients were divided into two groups, depending on the used methods of surgical treatment: Group 1-Lynn (58.6% of patients), group 2-rear miektomia (41.4% of patients). In the near period through 3 months after surgery in a group 1 good results reported for 34%, satisfactory-in the same way at 34%, unsatisfactory-32% of children. In Group 2 the good result was 33.3%, satisfactory-by 27.8%, unsatisfactory-38.9% have children. In the long term through 12 months after surgery in a group 1 good results reported for 55%, satisfactory-45% have children; There were no unsatisfactory results. In Group 2 the good result was at 55.6%, satisfactory-44.4% have children; There were no unsatisfactory results. Complications in the immediate postoperative period (2.9%), 6 were patients. In Group 1 (n = 119), complications were noted in 1.7% of patients, and in Group 2 (n = 84) - 4.8% of patients. On quality of life in comparison with preoperation data in both groups had a positive dynamics, but in Group 1 the results reliably surpassed those of Group 2 and is close to normal. But even in the distant postoperative quality of life indicators have not reached normal parameters in any of the above groups.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016;6(3):27-30
pages 27-30 views

USAGE OF SELECTIVE β1-BLOCKER ATENOLOL IN CHILDREN WITH A SEVERE BURN TRAUMA

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

Abstract

Relevancy: hypermetabolic response caused by the increased level of catecholamines accompanies a severe burn trauma, whereas β-adrenoblockers, decreasing the action of endogenous catecholamines, enable to reduce the load on the myocardium and decrease the pronounced symptoms of hypermetabolism. Purpose of the study: determination of the possibility and safety of using β1-blocker of atenolol in children in hyperdynamic phase of the burn damage accompanied by tachycardia and arterial hypertension. Materials and methods: the prospective open randomized study included 24 children with a burn trauma on the total body surface area (TBSA) from 30 to 80% accompanied by the hyperdynamic type of hemodynamics (cardiac index > 6 l/min/m2) aged 6 to 18 admitted to the department of resuscitation and intensive therapy of G.N. Speransky Children’s State Clinical Hospital No. 9, Moscow, from January 1, 11 to December 31, 15. Selective β1-blocker of atenolol at 4 mg/kg/day is added to the therapy of the basic group and intensive therapy without β1-blockers is intended for the control group. The study lasts 5 days. Results: in the studies they used selective β1- blocker of atenolol and in foreign clinics they use propranolol for these purposes. We managed to decrease the heart rate for 20-25% of the initial one but the tendency to tachycardia preserved during the entire study. Recovery of arterial pressure, systolic output index and DO2I was observed which indicates at the decrease of hypermetabolism. No complications were observed.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016;6(3):73-80
pages 73-80 views

INTOSSUSCEPTION IN CHILDREN: CLINICAL AND LABORATORY CRITERIA FOUND IN INTESTINAL NECROSIS

Bondarenko N.S., Kagan A.V., Nemilova T.K., Kotin A.N.

Abstract

Purpose of the study: determine clinical and laboratory signs in patients with invagination enabling to suspect development of irreversible circulation disturbances in the intussusceptum. Materials and methods. The results of treatment of 216 patients aged 2 months to 15 years old with the intestinal intussusceptum and complications from 2000 to 2015 were analyzed in 146 boys (67%) and 70 girls (33%). Intussusception was the most frequently met at the age of 5 to 11 months old (123 children - 57%). The main symptoms of intussusception were attack-like anxiety in 197 patents (91%), vomiting in 164 (75%), blood admixture in feces in 53 (24%) and volumetric formation in the abdomen in 103 (47%) found on palpation. Symptoms of intoxication and dehydration were found in all the patients with intussusception complications. Results. Conservative treatment (pneumodisinvagination) was performed in 168 children. 48 patients were operated. Irreversible circulation disturbances were found in 6 (12.5%) patients only. Clinical and laboratory criteria such as fatigue, vomiting with bile, blood in feces, fever, pronounced leukocytosis, electrolytic disturbances, change in the acid-base balance (metabolic acidosis), increased level of lactate indicating at the high risk of intestinal necrosis are found in patients with irreversible circulatory disturbances in the intussusceptum. Conclusions. There are signs of irreversible circulatory disturbances in the intussusceptum. It’s the combination of clinical and laboratory criteria but not every separate sign that proves there is a high risk of irreversible circulatory disturbances in the intussusceptum and which is the ground for a surgery.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016;6(3):31-34
pages 31-34 views

RATIONAL CHOICE OF TACTICS OF CONSERVATIVE AND SURGICAL TREATMENT OF CHEMICAL ESOPHAGEAL BURNS IN CHILDREN

Ormantaev K.S., Tursunov K.T., Myrzakhmet S.A., Sagymbayeva A.A.

Abstract

The frequency of basic chemical agents, clinical and diagnostic features and effectiveness of treatment of chemical burns of the esophagus were studied from 574 children in this article. The effectiveness of complex conservative treatment achieved in 516 (90%) cases. In 58 (10%) cases were performed probing program bougienage for string conductor, prolonged intubation of the esophagus were fitted in 15 children. Simultaneous retrosternal kolonoezofagoplastic with the creation of antireflux colonogastroanastomoz was performed in 5 children with total esophageal stenosis. Retrocolic gastroeyunoanastomoz was produced by the method after Ru in 2 cases, due to cicatricial pyloric stenosis gastric. Complications in the form of a fistula in the upper colonoezofagoanastomoz zone was observed in only one case.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016;6(3):35-39
pages 35-39 views

RARE REGIONAL FORMS OF ANORECTAL MALFORMATIONS IN GIRLS. DIAGNOSTICS AND TACTICS OF TREATMENT

Ergashev N.S., Otamuradov F.A.

Abstract

The article states data on the frequency of rare, the so-called regional forms of ARM in 50 girls examined at out clinic in 2004-2015. Clinical and anatomical peculiarities of separate nosological forms are provided in detail. The concomitant abnormalities and surgical tactics are analyzed.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016;6(3):40-44
pages 40-44 views

PREDICTORS OF SURVIVAL IN INFANTS WITH ACUTE RENAL FAILURE

Latypov I.Z., Akhmetshin R.Z., Mironov P.I.

Abstract

The purpose of our trial was to evaluate the predictors of unfavorable outcome in infants with acute renal failure (ARF) when using peritoneal dialysis (PD). Methods. Design: retrospective, observational study. We performed PD in 31 patients (aged 2 to 37 months; with the average age of 24.6+8.3 months) within 2009-2015. ARF severity was assessed following RIFLE and AKIN. Lethality, treatment duration at ICU were considered as end points. PD was performed on the 5+0.7 day from the onset of the disease and 2.1+07 days of admittance. PD duration was 13.6+5.1 days. Treatment duration at ICU was 23.2+3.1 days. Results. Three fourth of the examined children had clinical signs of systemic inflammatory response; primary site of infection almost in every patient was the intestine and they had anuria. At the moment of dialysis renal failure based on the RIFLE criteria was observed in 9 patients, renal insufficiency in 22, 2 stage under AKIN classification. Conclusions. The most significant predictors of lethal outcome in ARF treated using PD in infants are the late onset of PD (insufficiency staged based on the RIFLE criteria) HR-1.8, multiple organ failure (HP-3.1) and preservation of diuresis rate less than 0.5 ml/kg/an hour (HR-2.4).
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016;6(3):45-50
pages 45-50 views

IMPEDANSOMETRY IN THE ESTIMATION OF ANESTESIOLOGICAL RISK IN CHILDREN WITH ACUTE LYMPHOBLASTIC LYPHOMA

Kurlykin A.V., Tseiltin G.Y., Spiridonova E.A.

Abstract

The article is devoted to the development of the method evaluating the severity of the condition and anestesiological risk of patients with acute lymphoblastic lymphoma. It is indicated that bioimpedansometry enables to reveal considerable tissue disbalance, nutritive disturbances, risks of dehydration and hypovolemia development. Decrease of functional reserves of the cardiovascular system against the background of chemoradiation therapy is found. Conclusion. On the basis of the conducted study the author offers to use bioimpedansometry as part of pre-operative study in patients with chemoradiation therapy.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016;6(3):51-58
pages 51-58 views

RISK FACTORS OF COMPLICATED COURSE OF DISEASES AND TRAUMAS OF THE KNEE JOINTS IN CHILDREN

Murga V.V., Rasskazov L.V., Rumyantseva G.N., Kartashyov V.N., Ivanov Y.N.

Abstract

Untimely diagnostics and inadequate treatment of diseases and injuries to the knee joints in childhood cause chronic pathology of the knee joint and development of severe complications in future. The purpose of the study is to establish risk factors of complications in surgical diseases of the knee joint. Clinical and anamnestic, functional and instrumental methods of examination of 183 patients aged 4 to 7 years old with a complicated (98 patients) and non-complicated (85 patients) course of surgical diseases of the knee joint were analyzed. It is established that burden of biological and genealogical anamnesis, low level and disharmonic physical development, extreme somatotypes, decreased level of resistance, disturbances in the sphere of neuropsychic development, connective tissue dysplasia are related to risk factors for these complications.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016;6(3):59-66
pages 59-66 views

Reviews

VACTERL ASSOCIATION OF INBORN BIRTH DEFECTS - A SURGEON’S OPINION

Kozlov Y.A., Kovalkov K.A., Chubko D.M., Baradieva P.Z., Timofeev A.D., Zvonkov D.A., Us G.P., Kuznetsova N.N.

Abstract

VACTERL association is a set of certain abnormalities in one newborn which include defects of the esophagus, rectum, heart, kidneys, vertebral column and extremities. Research papers devoted to the study of this complex disease are still rare. The majority of researchers insist that the syndrome was composed at least of three components (abnormalities of vertebra, tracheoesophageal fistula and anal atresia) though others believe that the constituents of VACTERL are constant. Treatment of the syndrome is usually restricted by surgeries which are needed to restore the esophagus, anus, eliminate abnormalities of the cardiovascular and excretory system and extremities. The scientific research is devoted to the study of VACTERL, correct interpretation of its components, determination of knowledge weaknesses and description of modern therapeutic approaches intended for the correction of surgical abnormalities included into the syndrome.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016;6(3):95-101
pages 95-101 views

NONPARASITIC SPLENIC CYSTS IN CHILDREN (ETIOLOGY, CLASSIFICATION, ORGAN PRESERVATION THERAPY)

Belyaeva A.V., Polyaev Y.A., Rosinov V.M.

Abstract

Historical and actual aspects of diagnostics and classification of nonparasitic cysts in children, risk of splenectomy and a specter of surgical technologies ensuring organ preservation treatment are presented in the article. Vies of authoritative followers of traditional (open) surgeries, endosurgical interventions and navigation accesses to the pathological center are reviewed. Advantages of using of different types of energy alongside with mechanical influence for the purpose of surgical hemostasis, deepithelialization of the cystic cavity, slerotherapy of its walls are shown. Perspectives of combined minimally invasive surgeries combining endovascular occlusion of vessels, feeding the cystic wall and ultrasound-guided puncture and drainage intervention are determined.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016;6(3):102-110
pages 102-110 views

SUCCINATE CONTAINING PREPARATIONS IN THE STRUCTURE OF THERAPEUTIC AGENTS IN PATIENTS IN CRITICAL CONDITIONS

Lazarev V.V., Gadomsky I.V.

Abstract

The presented data are based on the publications freely accessed from PudMed, Scopus, Medline databases, reviewed medical journals, monographies, clinical recommendations, and guidance manuals. The issues of using succinate containing preparations in the complex of therapeutic preparations in patients in critical conditions are reviewed. In spite of ambiguous position in relation to effective usage of the preparations in domestic and foreign medical practice, the data of widely usage of these preparations in patients of different age and in various pathological conditions are submitted.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016;6(3):111-116
pages 111-116 views

MEDICAL TECHNOLOGIES OF TREATING CHILDREN WITH DIAPHYSEAL FRACTURES OF THE TIBIA

Rosinov V.M., Yandiev S.I., Kolyagin D.V.

Abstract

The article stresses the evolution of views on the problem of treatment of children and adolescents with diaphyseal fractures of the shin bones and a set of actual medical technologies implemented in these patients. The views of authoritative followers of conservative therapy and supporters of medical schools adhering to the ideology of stable and functional osteosynthesis are reviewed. The basic tendencies of development of surgery of injuries in pediatrics are found and effective and safe methods of surgery of patients with instable diaphyseal fractures of the tibia on the basis of using the closed intramedullary osteosynthesis with the original blocking rod are substantiated.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016;6(3):118-125
pages 118-125 views

Lectures

MODERN TECHNOLOGIES OF PARENTERAL NUTRITION IN NEWBORNS AND INFANTS

Erpulyova Y.V., Chugunova O.L., Weinstein N.P.

Abstract

The article stresses the necessity to use modern technologies of parenteral nutrition in newborns and infants. The problem is urgent as in parenteral nutrition doctors unfortunately fail to pay needed attention to the terms and dosage of fatty emulsions leaving behind such important components of parenteral nutrition as microelements and vitamins. The authors consider the terms of administration and dosage of fatty emulsions, vitamins and microelements in children under 3 years old. The importance of parenteral nutrition in complex therapy of nursing in newborns and infants is revealed.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016;6(3):87-94
pages 87-94 views

Clinical Practice Guidelines

CONTROLLED MYOPLEGIA IN PEDIATRICS: EXISTING CLINICAL RECOMMENDATIONS AND REALITIES OF PRACTICE (Based on materials of professional Expert Boards of 2013-2014)

Lazarev V.V.

Abstract

The article deals with the data found in the course of two interviews with anesthesiologists within expert boards with 87 participants in total with different time record, age and professional level when estimating the usage of suxamethonium and nondepolarizing myorelaxants, methods and medicines in elimination of residual curarization, usage of monitoring during control of myoplegia level in children. The obtained results make us conclude that the majority of interviewed anesthesiologists never or seldom use suxamethonium in children and report residual curarization whereas 25% believe it to be insignificant, up to 60% prefer using different medications to eliminate it and around 30% never use hardware monitoring of myoplegia as they lack the possibility.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016;6(3):126-130
pages 126-130 views

News

INFORMATION

Article E.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016;6(3):142-145
pages 142-145 views

Biography

ANNIVERSARIES

Article E.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016;6(3):132-141
pages 132-141 views

NECROLOGUE

Article E.
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2016;6(3):146-151
pages 146-151 views


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