The editorial presents a report on the work of the Chief Pediatric Surgeon of the Ministry of Health of Russia for 2022. From the very beginning of his activity, he established regular interaction with the chief supernumerary pediatric surgeons and executive and legislative authorities of the regions of the Russian Federation, both remotely and visiting surgical clinics in 15 cities. Much attention was paid to the improvement of pediatric surgical care in the Far East with repeated trips to this region to prepare a program for the creation of interregional centers for specialized surgical care in the most popular medical specialties. As a result of joint work with leading specialists of the Russian Association of Pediatric Surgeons and chief pediatric surgeons of the regions of the Russian Federation, the first Regulations on Interregional Centers for Neonatal Surgery was created. Chief Pediatric Surgeons organized surgical care for children in the special military operation zone and border regions with business trips to Taganrog, Rostov-on-Don and Lugansk. Throughout the year, is coordinated round-the-clock assistance to injured children, dozens of telemedicine consultations were held. As a result of a systematic survey of the chief supernumerary pediatric surgeons of the regions of the Russian Federation, a consolidated report on the activities of the pediatric surgical service of the Russian Federation for 2021 was formed, which was necessary to develop prospects for its further development. The work plans of the chief pediatric surgeon for 2023 include the completion of important documents for the specialty: the The procedure for providing surgical care to children and the Professional standard for a pediatric surgeon. There is also a task to implement the concept of interregional neonatal surgery centers in the Far Eastern Federal District, expert, educational work and audit of children's surgical clinics will be continued.
{"title":"Report on the work of the Chief Pediatric Surgeon of the Ministry of Health of the Russian Federation in 2022","authors":"D. Morozov","doi":"10.17816/psaic1490","DOIUrl":"https://doi.org/10.17816/psaic1490","url":null,"abstract":"The editorial presents a report on the work of the Chief Pediatric Surgeon of the Ministry of Health of Russia for 2022. From the very beginning of his activity, he established regular interaction with the chief supernumerary pediatric surgeons and executive and legislative authorities of the regions of the Russian Federation, both remotely and visiting surgical clinics in 15 cities. Much attention was paid to the improvement of pediatric surgical care in the Far East with repeated trips to this region to prepare a program for the creation of interregional centers for specialized surgical care in the most popular medical specialties. As a result of joint work with leading specialists of the Russian Association of Pediatric Surgeons and chief pediatric surgeons of the regions of the Russian Federation, the first Regulations on Interregional Centers for Neonatal Surgery was created. Chief Pediatric Surgeons organized surgical care for children in the special military operation zone and border regions with business trips to Taganrog, Rostov-on-Don and Lugansk. Throughout the year, is coordinated round-the-clock assistance to injured children, dozens of telemedicine consultations were held. As a result of a systematic survey of the chief supernumerary pediatric surgeons of the regions of the Russian Federation, a consolidated report on the activities of the pediatric surgical service of the Russian Federation for 2021 was formed, which was necessary to develop prospects for its further development. \u0000The work plans of the chief pediatric surgeon for 2023 include the completion of important documents for the specialty: the The procedure for providing surgical care to children and the Professional standard for a pediatric surgeon. There is also a task to implement the concept of interregional neonatal surgery centers in the Far Eastern Federal District, expert, educational work and audit of children's surgical clinics will be continued.","PeriodicalId":437552,"journal":{"name":"Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care","volume":"166 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133250921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
O. Mokrushina, A. Razumovskiy, E. V. Yudina, I. Afukov, V. Shumikhin, S. Smirnova, E. Zilbert, L. Petrova, N. Erokhina, R. V. Halafov, T.O. Svetlichnaya
BACKGROUND: The right-sided congenital diaphragmatic hernia is the rare pathology. Results of diagnostics, prognosis and treatment usally published as a collection of cases. AIM: Comparition of treatment results of congenital diaphragmatic hernia with the liver as its content in dependancy of the side. MATERIALS AND METHODS: We present a retrospective analysis of 50 newborn patients with congenital diaphragmatic hernia. Patiens were divided in two groups, first with right-sided (19 patients), and second with left-sided hernia (31 patients). Groups were compared by gender and weigth. Comparition criteria was the results of prenatal and postnatal diagnostics, intraoperative data, postoperative period, complications and outcomes. RESULTS: We found predominance of prenatal diagnosis in the second group (48% vs 84%, p = 0,001). The lung-to-head circumference ratio were the same in both groups (0,52 in first, 0,46 in second, p = 0,058). Chance to use thoracoscopic approach in the second group was higer in 5,7 times (48% vs 84%). Postoperative period was easier in the group of right-sided congenital diaphragmatic hernia: artificial ventilation lasted on average 8 days (min 3; max 28) versus 11 (min 4; max 50) days in the first group (p = 0,036). Hospital stay was significantly lower in the second group 18 days (min 12; max 28), versus 50 days in the first group (min 13; max 64), p = 0,011. Recovery chance in patients with right-sided hernia was higher (45% vs 79%, confidence interval 0,0590,814). CONCLUSIONS: Every type of diaphragmatic hernia, including right-sided location, need to be the subgect of research of high compitantive center. Prognostic criteria for right-sided congenital diaphragmatic hernia require furter advanced study, wich is possible only in case of concentration of patients in the same center.
背景:右侧先天性膈疝是一种罕见的疾病。诊断、预后和治疗结果通常作为病例集发表。目的:比较以肝为内容的先天性膈疝侧边依赖性的治疗效果。材料与方法:我们对50例新生儿先天性膈疝患者进行回顾性分析。患者分为两组，一组为右侧疝(19例)，二组为左侧疝(31例)。各组按性别和体重进行比较。比较标准为产前和产后诊断结果、术中资料、术后时间、并发症和结局。结果:我们发现产前诊断在第二组中占优势(48% vs 84%， p = 0.001)。两组肺头围比相同(第一组为0.52，第二组为0.46,p = 0.058)。第二组采用胸腔镜入路的几率为5,7次(48%对84%)。右侧先天性膈疝组术后时间较短，人工通气时间平均为8天(最短3天;最大28)vs 11(最小4;第一组最多50天(p = 0.036)。第二组患者住院时间明显缩短18天(最短12天;最长28天)，而第一组为50天(最短13天;最大64)，p = 0,011。右侧疝患者的康复率更高(45% vs 79%，可信区间0,0590,814)。结论:每一种类型的膈疝，包括右侧位置，都需要成为高竞争中心的研究对象。右侧先天性膈疝的预后标准需要进一步的深入研究，这只有在患者集中在同一中心的情况下才有可能。
{"title":"The results of treatment of newborns with right-sided and left-sided intrathoracic localization of the liver with diaphragmatic hernia","authors":"O. Mokrushina, A. Razumovskiy, E. V. Yudina, I. Afukov, V. Shumikhin, S. Smirnova, E. Zilbert, L. Petrova, N. Erokhina, R. V. Halafov, T.O. Svetlichnaya","doi":"10.17816/psaic1291","DOIUrl":"https://doi.org/10.17816/psaic1291","url":null,"abstract":"BACKGROUND: The right-sided congenital diaphragmatic hernia is the rare pathology. Results of diagnostics, prognosis and treatment usally published as a collection of cases. \u0000AIM: Comparition of treatment results of congenital diaphragmatic hernia with the liver as its content in dependancy of the side. \u0000MATERIALS AND METHODS: We present a retrospective analysis of 50 newborn patients with congenital diaphragmatic hernia. Patiens were divided in two groups, first with right-sided (19 patients), and second with left-sided hernia (31 patients). Groups were compared by gender and weigth. Comparition criteria was the results of prenatal and postnatal diagnostics, intraoperative data, postoperative period, complications and outcomes. \u0000RESULTS: We found predominance of prenatal diagnosis in the second group (48% vs 84%, p = 0,001). The lung-to-head circumference ratio were the same in both groups (0,52 in first, 0,46 in second, p = 0,058). Chance to use thoracoscopic approach in the second group was higer in 5,7 times (48% vs 84%). Postoperative period was easier in the group of right-sided congenital diaphragmatic hernia: artificial ventilation lasted on average 8 days (min 3; max 28) versus 11 (min 4; max 50) days in the first group (p = 0,036). \u0000Hospital stay was significantly lower in the second group 18 days (min 12; max 28), versus 50 days in the first group (min 13; max 64), p = 0,011. Recovery chance in patients with right-sided hernia was higher (45% vs 79%, confidence interval 0,0590,814). \u0000CONCLUSIONS: Every type of diaphragmatic hernia, including right-sided location, need to be the subgect of research of high compitantive center. Prognostic criteria for right-sided congenital diaphragmatic hernia require furter advanced study, wich is possible only in case of concentration of patients in the same center.","PeriodicalId":437552,"journal":{"name":"Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123526047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Saidkhasan M. Bataev, K. S. Tsilenko, A. Osipov, A. Reshetnikov, A. S. Bataev, S. P. Sosnova
The paper provides a review of domestic and foreign literature on photodynamic therapy, which is mainly used by oncologists in the treatment of adult patients and is little known to pediatric surgeons. The aim of this work is to describe the history of the formation, principles and mechanisms of photodynamic therapy, the main groups of photo sensitizers, areas of clinical application and prospects for wider use in pediatric surgery. Literature sources were searched in the databases in Russian eLibrary and English Medline and PubMed. The following keywords were specified for the search: photodynamic therapy, dysplasia, metaplasia, angiodysplasia, Barretts syndrome, children. 865 papers were found, of which 66 were fully consistent with the purpose of our study and were analyzed. The data presented in the review of the literature indicate the high efficiency of the method of photodynamic therapy in the treatment of a number of diseases, mostly in oncology. In addition, the work contains theoretical calculations and separate reports on the effectiveness of the method in the treatment of dysplasia of varying degrees in children. Taking into account the minimally invasiveness of the technique, the relative cheapness of photosensitizers and equipment for generating laser radiation, it is possible to create a basis for conducting research on the treatment of children with various dysplasias, epithelial metaplasia, and vascular malformations. Another promising direction is the development of technologies for the use of photodynamic methods for the treatment of severe forms of pyoinflammatory diseases in children. In childhood surgery, there are nosological forms of diseases where the method of photodynamic therapy has the prospect of effective use. Limitations on the scope of this article do not allow for a detailed analysis of the existing experience in the use of photodynamic therapy in children, which will need to be done in subsequent works.
{"title":"Fundamentals of photodynamic therapy, clinical practice and prospects for use in pediatric surgery. Review","authors":"Saidkhasan M. Bataev, K. S. Tsilenko, A. Osipov, A. Reshetnikov, A. S. Bataev, S. P. Sosnova","doi":"10.17816/psaic936","DOIUrl":"https://doi.org/10.17816/psaic936","url":null,"abstract":"The paper provides a review of domestic and foreign literature on photodynamic therapy, which is mainly used by oncologists in the treatment of adult patients and is little known to pediatric surgeons. The aim of this work is to describe the history of the formation, principles and mechanisms of photodynamic therapy, the main groups of photo sensitizers, areas of clinical application and prospects for wider use in pediatric surgery. \u0000Literature sources were searched in the databases in Russian eLibrary and English Medline and PubMed. The following keywords were specified for the search: photodynamic therapy, dysplasia, metaplasia, angiodysplasia, Barretts syndrome, children. 865 papers were found, of which 66 were fully consistent with the purpose of our study and were analyzed. \u0000The data presented in the review of the literature indicate the high efficiency of the method of photodynamic therapy in the treatment of a number of diseases, mostly in oncology. In addition, the work contains theoretical calculations and separate reports on the effectiveness of the method in the treatment of dysplasia of varying degrees in children. \u0000Taking into account the minimally invasiveness of the technique, the relative cheapness of photosensitizers and equipment for generating laser radiation, it is possible to create a basis for conducting research on the treatment of children with various dysplasias, epithelial metaplasia, and vascular malformations. Another promising direction is the development of technologies for the use of photodynamic methods for the treatment of severe forms of pyoinflammatory diseases in children. \u0000In childhood surgery, there are nosological forms of diseases where the method of photodynamic therapy has the prospect of effective use. Limitations on the scope of this article do not allow for a detailed analysis of the existing experience in the use of photodynamic therapy in children, which will need to be done in subsequent works.","PeriodicalId":437552,"journal":{"name":"Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123970091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. K. Shangareeva, N. T. Absalyamova, Regina R. Fedorova, I. Tikhonova, Rano Kh. Mukhamedova, A. K. Alibaev, G. I. Minibaeva
Currently, there is more and more data on new manifestations of COVID-19, such as multisystem inflammatory syndrome in children, which occurs with severe complications, among which cases of pneumothorax have been recorded. The article presents the experience of treating 4 newborns with a new coronovirus infection who were admitted to the clinic during 2021. In all clinical cases, children were born to mothers with a burdened obstetric history. All children had a positive RNA polymerase chain reaction for SARS-CoV-2. Children were admitted with signs of respiratory, cerebral insufficiency, gastrointestinal syndrome and metabolic disorders. The clinical picture and laboratory data corresponded to the definition of a multisystem inflammatory syndrome and was characterized not only by lung damage, but also by changes in other organs. Pneumothorax was diagnosed on days 1521. In all children, a tension pneumothorax developed on the right, in the first two cases against the background of mechanical ventilation, in the remaining two with spontaneous breathing with additional oxygenation. In one case, the pneumothorax was bilateral. Drainage of the pleural cavity in three children was carried out according to Bulau and in one case with active aspiration. Pneumothorax resolved after 414 days. Computed tomography of the chest, performed during the period of rehabilitation treatment, shows pronounced sclerotic and bullous changes in the lung parenchyma. All patients were discharged from the hospital in a satisfactory condition. Since in all the above cases, pneumothorax occurred in newborns with a burdened obstetric history of mothers, it is difficult to differentiate the occurrence of pneumothorax associated with the underlying disease, the course of labor, complications of therapy, from the disease associated with COVID-19. Stronger evidence is needed from larger datasets and rigorous analysis.
{"title":"Pneumothorax in newborns with multisystem inflammatory syndrome associated with COVID-19: a case reports","authors":"R. K. Shangareeva, N. T. Absalyamova, Regina R. Fedorova, I. Tikhonova, Rano Kh. Mukhamedova, A. K. Alibaev, G. I. Minibaeva","doi":"10.17816/psaic1303","DOIUrl":"https://doi.org/10.17816/psaic1303","url":null,"abstract":"Currently, there is more and more data on new manifestations of COVID-19, such as multisystem inflammatory syndrome in children, which occurs with severe complications, among which cases of pneumothorax have been recorded. \u0000The article presents the experience of treating 4 newborns with a new coronovirus infection who were admitted to the clinic during 2021. In all clinical cases, children were born to mothers with a burdened obstetric history. All children had a positive RNA polymerase chain reaction for SARS-CoV-2. Children were admitted with signs of respiratory, cerebral insufficiency, gastrointestinal syndrome and metabolic disorders. The clinical picture and laboratory data corresponded to the definition of a multisystem inflammatory syndrome and was characterized not only by lung damage, but also by changes in other organs. Pneumothorax was diagnosed on days 1521. In all children, a tension pneumothorax developed on the right, in the first two cases against the background of mechanical ventilation, in the remaining two with spontaneous breathing with additional oxygenation. In one case, the pneumothorax was bilateral. Drainage of the pleural cavity in three children was carried out according to Bulau and in one case with active aspiration. Pneumothorax resolved after 414 days. Computed tomography of the chest, performed during the period of rehabilitation treatment, shows pronounced sclerotic and bullous changes in the lung parenchyma. All patients were discharged from the hospital in a satisfactory condition. \u0000Since in all the above cases, pneumothorax occurred in newborns with a burdened obstetric history of mothers, it is difficult to differentiate the occurrence of pneumothorax associated with the underlying disease, the course of labor, complications of therapy, from the disease associated with COVID-19. Stronger evidence is needed from larger datasets and rigorous analysis.","PeriodicalId":437552,"journal":{"name":"Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117040913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND: Assessment of the clinical condition, prediction of risks and possible outcomes during the transfer of newborns remains an important part of the work of transport teams. Respiratory disorders remain a significant indication for transfer to medical organizations of a higher level of care. AIM: To study the predictive value of the parameters of respiratory support in newborns requiring medical evacuation for the outcomes of treatment. MATERIALS AND METHODS: The observational, cohort, retrospective study included data from neonatal to patients on ventilators (286 newborns) in the period from August 1, 2017 to December 31, 2018. Anamnesis parameters, intensive care volume, respiratory support settings, and assessments on scales (KSHONN, NTISS, TRIPS) were evaluated. Analyzed: 24-hours mortality, 7 days mortality, hospital mortality, air leakage syndrome. The assessment and comparison of the predictive value of the parameters in relation to the hospital outcomes was performed. RESULTS: The AUC ROC of SpO2/FiO2 for predicting 24-hours mortality was 0.984 [0.9661.000], which is significantly higher than the ROC of the saturation oxygenation index (AUC 0.972 [0.9490.995], p = 0.004). The area under the ROC of the 24-hours mortality on the TRIPS scale does not significantly differ from the saturation index of oxygenation (AUC 0.972 [0.9490.995], p = 0.113) and the mean airway pressure (AUC 0.943 [0.8841.000], p = 0.107). When predicting 7-day mortality, the saturation oxygenation index has AUC ROC (0.702 [0.5490.854]) significantly lower than AUC ROC for SpO2/FiO2 (0.762 [0.6380.887], p = 0.001). SpO2/FiO2 predicts total mortality with AUC ROC (0.759 [0.6770.841]). CONCLUSIONS: The mean airway pressure, saturation oxygenation index and SpO2/FiO2 have a high (AUC 0,9) predictive value for 24-hours mortality, while only SpO2/FiO2 reliably predicts total mortality with AUC ROC 0,7.
背景:在新生儿转移过程中评估临床状况，预测风险和可能的结果仍然是转运团队工作的重要组成部分。呼吸系统疾病仍然是转移到更高护理水平的医疗机构的一个重要指标。目的:探讨需要医疗后送的新生儿呼吸支持参数对治疗结果的预测价值。材料与方法:该观察性、队列性、回顾性研究纳入了2017年8月1日至2018年12月31日期间新生儿至使用呼吸机患者(286名新生儿)的数据。评估了记忆参数、重症监护量、呼吸支持设置和量表评估(KSHONN、NTISS、TRIPS)。分析:24小时死亡率、7天死亡率、住院死亡率、漏气综合征。评估和比较与医院预后相关的参数的预测值。结果:SpO2/FiO2预测24小时死亡率的AUC ROC为0.984[0.9661.000]，显著高于饱和氧合指数(AUC 0.972 [0.9490.995]， p = 0.004)。24小时死亡率在TRIPS量表上的ROC下面积与氧合饱和度指数(AUC 0.972 [0.949 - 0.995]， p = 0.113)和平均气道压力(AUC 0.943 [0.8841.000]， p = 0.107)无显著差异。在预测7天死亡率时，饱和氧合指数AUC ROC(0.702[0.5490.854])显著低于SpO2/FiO2的AUC ROC (0.762 [0.63800.887]， p = 0.001)。SpO2/FiO2预测总死亡率，AUC ROC(0.759[0.6770.841])。结论:平均气道压、饱和氧合指数和SpO2/FiO2对24小时死亡率具有较高的预测价值(AUC 0.9)，而SpO2/FiO2仅可靠地预测总死亡率，AUC ROC为0.7。
{"title":"Respiratory parameters as a predictor of hospital outcomes in newborns requiring medical evacuation","authors":"R. Mukhametshin, O. Kovtun, N. S. Davydova","doi":"10.17816/psaic1292","DOIUrl":"https://doi.org/10.17816/psaic1292","url":null,"abstract":"BACKGROUND: Assessment of the clinical condition, prediction of risks and possible outcomes during the transfer of newborns remains an important part of the work of transport teams. Respiratory disorders remain a significant indication for transfer to medical organizations of a higher level of care. \u0000AIM: To study the predictive value of the parameters of respiratory support in newborns requiring medical evacuation for the outcomes of treatment. \u0000MATERIALS AND METHODS: The observational, cohort, retrospective study included data from neonatal to patients on ventilators (286 newborns) in the period from August 1, 2017 to December 31, 2018. Anamnesis parameters, intensive care volume, respiratory support settings, and assessments on scales (KSHONN, NTISS, TRIPS) were evaluated. Analyzed: 24-hours mortality, 7 days mortality, hospital mortality, air leakage syndrome. The assessment and comparison of the predictive value of the parameters in relation to the hospital outcomes was performed. \u0000RESULTS: The AUC ROC of SpO2/FiO2 for predicting 24-hours mortality was 0.984 [0.9661.000], which is significantly higher than the ROC of the saturation oxygenation index (AUC 0.972 [0.9490.995], p = 0.004). The area under the ROC of the 24-hours mortality on the TRIPS scale does not significantly differ from the saturation index of oxygenation (AUC 0.972 [0.9490.995], p = 0.113) and the mean airway pressure (AUC 0.943 [0.8841.000], p = 0.107). When predicting 7-day mortality, the saturation oxygenation index has AUC ROC (0.702 [0.5490.854]) significantly lower than AUC ROC for SpO2/FiO2 (0.762 [0.6380.887], p = 0.001). SpO2/FiO2 predicts total mortality with AUC ROC (0.759 [0.6770.841]). \u0000CONCLUSIONS: The mean airway pressure, saturation oxygenation index and SpO2/FiO2 have a high (AUC 0,9) predictive value for 24-hours mortality, while only SpO2/FiO2 reliably predicts total mortality with AUC ROC 0,7.","PeriodicalId":437552,"journal":{"name":"Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care","volume":"246 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116047019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Inna S. Schneider, N. Tsap, E. V. Gaydysheva, Maxim Yu. Timoshinov, Mikhail N. Ekimov, Snezhana E. Smirnova
Congenital malformation of the gastrointestinal tract in a rare case can cause partial obstruction and masquerade as functional disorders of the intestine for a long time. Atypical clinic of membranous gastric obstruction causes difficulties in diagnosis and determination of treatment tactics. The aim to determine and present to the surgical community the features of diagnosis, surgical treatment, possible complications of a rare malformation of the stomach in children in the form of a stomach membrane. The paper presents a clinical case of the stomach membrane in a child 1 year 10 months old with complaints of vomiting after each meal, bloating, lethargy for one month. The results of ultrasonography, X-ray examination with the passage of a contrast agent through the gastrointestinal tract, fibrogastroduodenoscopy established anatomical changes in the stomach in the form of pyloric stenosis up to 0.40.5 cm in diameter. Intraoperative revision of the stomach, supplemented by intraluminal endoscopic support, made it possible to reliably establish the presence of a perforated pyloric membrane. The membrane is radically cut along the entire circumference at the level of its base. The next postoperative period was uneventful. After 1.5 months, the child was again admitted to the pediatric surgical department on an emergency basis with a clinic of intestinal obstruction, including the childs anxiety, repeated vomiting, and bloating. X-ray and endoscopic picture corresponded to the diagnosis of cicatricial stenosis of the pyloric part of the stomach. Taking into account the presence of cicatricial deformity, due to the high risk of complications during resection of the stenotic part of the stomach and the imposition of gastroduodenoanastomosis, a bypass retrocolic gastrojejunoanastomosis with Brown fistula was formed. When examining a child of a child in the late postoperative period, no complications were identified. The presented clinical case confirms that congenital malformations of the gastrointestinal tract in the form of stenoses and membranes can have a long stage of compensation, their diagnosis is based on a comprehensive examination of the child using radiopaque and endoscopic studies.
{"title":"Chronic obstruction of the stomach as a result of congenital malformation in a child of 1 year 10 months. Case report","authors":"Inna S. Schneider, N. Tsap, E. V. Gaydysheva, Maxim Yu. Timoshinov, Mikhail N. Ekimov, Snezhana E. Smirnova","doi":"10.17816/psaic1283","DOIUrl":"https://doi.org/10.17816/psaic1283","url":null,"abstract":"Congenital malformation of the gastrointestinal tract in a rare case can cause partial obstruction and masquerade as functional disorders of the intestine for a long time. Atypical clinic of membranous gastric obstruction causes difficulties in diagnosis and determination of treatment tactics. The aim to determine and present to the surgical community the features of diagnosis, surgical treatment, possible complications of a rare malformation of the stomach in children in the form of a stomach membrane. \u0000The paper presents a clinical case of the stomach membrane in a child 1 year 10 months old with complaints of vomiting after each meal, bloating, lethargy for one month. The results of ultrasonography, X-ray examination with the passage of a contrast agent through the gastrointestinal tract, fibrogastroduodenoscopy established anatomical changes in the stomach in the form of pyloric stenosis up to 0.40.5 cm in diameter. Intraoperative revision of the stomach, supplemented by intraluminal endoscopic support, made it possible to reliably establish the presence of a perforated pyloric membrane. The membrane is radically cut along the entire circumference at the level of its base. The next postoperative period was uneventful. After 1.5 months, the child was again admitted to the pediatric surgical department on an emergency basis with a clinic of intestinal obstruction, including the childs anxiety, repeated vomiting, and bloating. X-ray and endoscopic picture corresponded to the diagnosis of cicatricial stenosis of the pyloric part of the stomach. Taking into account the presence of cicatricial deformity, due to the high risk of complications during resection of the stenotic part of the stomach and the imposition of gastroduodenoanastomosis, a bypass retrocolic gastrojejunoanastomosis with Brown fistula was formed. When examining a child of a child in the late postoperative period, no complications were identified. \u0000The presented clinical case confirms that congenital malformations of the gastrointestinal tract in the form of stenoses and membranes can have a long stage of compensation, their diagnosis is based on a comprehensive examination of the child using radiopaque and endoscopic studies.","PeriodicalId":437552,"journal":{"name":"Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130609313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Commentary on the article Schneider IS, Tsap NA, Gaydysheva EV, Timoshinov MYu, Ekimov MN, Smirnova SE. Chronic obstruction of the stomach as a result of congenital malformation in a child of 1.10 months. Case report published in the Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2022;12(4):513520. (In Russ.) DOI: https://doi.org/10.17816/psaic1283
{"title":"Commentary on the article \"Chronic obstruction of the stomach as a result of congenital malformation in a child of 1.10 months. Case report\"","authors":"Y. Sokolov","doi":"10.17816/psaic1485","DOIUrl":"https://doi.org/10.17816/psaic1485","url":null,"abstract":"Commentary on the article Schneider IS, Tsap NA, Gaydysheva EV, Timoshinov MYu, Ekimov MN, Smirnova SE. Chronic obstruction of the stomach as a result of congenital malformation in a child of 1.10 months. Case report published in the Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2022;12(4):513520. (In Russ.) DOI: https://doi.org/10.17816/psaic1283","PeriodicalId":437552,"journal":{"name":"Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128536777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maria Yu. Yanitskaya, O. Kharkova, N. V. Markov, N. V. Zolotarev
BACKGROUND: The diagnosis of acute appendicitis in children is often established late, which leads to complications, lethal outcomes are recorded. AIM: To identify and analyze the factors contributing to the late diagnosis of acute appendicitis in children. MATERIALS AND METHODS: A retrospective analysis of 279 case histories of children was carried out. The duration of symptoms is divided into time 1 (before hospitalization) and time 2 (from hospitalization to surgery). Patients were divided into two groups: 1st with destructive uncomplicated appendicitis (phlegmonous, gangrenous), 2nd with complicated appendicitis (unrestricted peritonitis, infiltrate, abscess). The causes of late hospitalization, symptoms indicated in the case histories, examinations performed, postoperative complications were analyzed. The diagnosis was established on the basis of intraoperative data, histological examination. RESULTS: In the 1st group, time 1 and time 2 were significantly less than in the 2nd (p 0.001; 0.028). Late presentation (24 hours) in 21.9%, misdiagnosis in 12.2% of cases. In the hospital, the observation of the patient 12 hours in 21.1% of patients. The frequency of presence / absence of a description of clinical and laboratory signs of acute appendicitis is from 100 to 19.7%. The 2nd group was characterized by: duration of symptoms 24 hours, repeated vomiting (p 0.001), febrile condition (p 0.001), increase in neutrophils 90% (8792%). Ultrasound examination with evaluation of the appendix in 20.1% of cases with a diagnostic accuracy of 89.3%. Laparoscopic appendectomy in 53.2% Alvarado scores are significantly higher in 2nd group (810) than in 1st group (79, p 0.001). In 1st group, complications were significantly less than 3.4% than in 2nd group 22.7 % (p 0.001). CONCLUSIONS: Factors contributing to the late diagnosis of appendicitis in children are: late treatment, diagnostic errors at the prehospital stage, incomplete clinical examination and observation, insufficient use of laboratory and instrumental methods.
{"title":"Factors contributing to the late diagnosis of appendicitis in children: the results of a retrospective study","authors":"Maria Yu. Yanitskaya, O. Kharkova, N. V. Markov, N. V. Zolotarev","doi":"10.17816/psaic1260","DOIUrl":"https://doi.org/10.17816/psaic1260","url":null,"abstract":"BACKGROUND: The diagnosis of acute appendicitis in children is often established late, which leads to complications, lethal outcomes are recorded. \u0000AIM: To identify and analyze the factors contributing to the late diagnosis of acute appendicitis in children. \u0000MATERIALS AND METHODS: A retrospective analysis of 279 case histories of children was carried out. The duration of symptoms is divided into time 1 (before hospitalization) and time 2 (from hospitalization to surgery). Patients were divided into two groups: 1st with destructive uncomplicated appendicitis (phlegmonous, gangrenous), 2nd with complicated appendicitis (unrestricted peritonitis, infiltrate, abscess). The causes of late hospitalization, symptoms indicated in the case histories, examinations performed, postoperative complications were analyzed. The diagnosis was established on the basis of intraoperative data, histological examination. \u0000RESULTS: In the 1st group, time 1 and time 2 were significantly less than in the 2nd (p 0.001; 0.028). Late presentation (24 hours) in 21.9%, misdiagnosis in 12.2% of cases. In the hospital, the observation of the patient 12 hours in 21.1% of patients. The frequency of presence / absence of a description of clinical and laboratory signs of acute appendicitis is from 100 to 19.7%. The 2nd group was characterized by: duration of symptoms 24 hours, repeated vomiting (p 0.001), febrile condition (p 0.001), increase in neutrophils 90% (8792%). Ultrasound examination with evaluation of the appendix in 20.1% of cases with a diagnostic accuracy of 89.3%. Laparoscopic appendectomy in 53.2% Alvarado scores are significantly higher in 2nd group (810) than in 1st group (79, p 0.001). In 1st group, complications were significantly less than 3.4% than in 2nd group 22.7 % (p 0.001). \u0000CONCLUSIONS: Factors contributing to the late diagnosis of appendicitis in children are: late treatment, diagnostic errors at the prehospital stage, incomplete clinical examination and observation, insufficient use of laboratory and instrumental methods.","PeriodicalId":437552,"journal":{"name":"Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127775142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The paper describes the professional activities and merits of the pediatric surgeon Viktor V. Nesterov in celebration of his anniversary.
本文描述的专业活动和功绩的儿科外科医生维克多·v·涅斯捷罗夫庆祝他的周年纪念日。
{"title":"To the 75th Anniversary of Viktor V. Nesterov","authors":"Valery F. Blandinsky","doi":"10.17816/psaic1309","DOIUrl":"https://doi.org/10.17816/psaic1309","url":null,"abstract":"The paper describes the professional activities and merits of the pediatric surgeon Viktor V. Nesterov in celebration of his anniversary.","PeriodicalId":437552,"journal":{"name":"Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124534814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Pavlushin, I. Porshennikov, Vladimir N. Pavlik, V. Tsyganok, A. Gramzin
Spontaneous perforation of the external biliary tract is an extremely rare pathology in childhood, presented in the literature by description of clinical cases. To date, a unified approach to the treatment of children with this pathology has not been developed. The paper presents a clinical case of spontaneous perforation of the anterior wall of the common hepatic duct in a child of seven months, with the development of bilioperitoneum against the background of obstruction of the common bile duct by bilirubin calculi. CASE REPORT. The disease began acutely with repeated vomiting, stool acholia, dark urine, and an increase in the size of the abdomen in a 7-month-old child. Examination in the hospital revealed ascites, cholecystitis and shadows of calculi in the projection of the hepatoduodenal ligament. According to the results of laparocentesis, bilioperitoneum was noted. The patient underwent laparotomy, 300 ml of serous-biliary effusion was removed from the abdominal cavity. On the anterior semicircle of the common hepatic duct there is a defect from which bile flows. Suturing of the perforation of the biliary tree, cholecystectomy and drainage of the external bile ducts through the stump of the cystic duct were performed. The cholangiostomy was removed after 1.5 months. Follow-up 1 year and 3 months, pathology is not determined during the examination. CONCLUSIONS. Sewing up the site of primary perforation with drainage of the external biliary tract can help accelerate the reparative process with a decrease in the risk of developing a biliary fistula. Performing primary reconstructive interventions on the abdominal cavity compromised by bilioperitoneum, in our opinion, is too risky.
{"title":"Spontaneous biliary perforation in a child: case report and review","authors":"P. Pavlushin, I. Porshennikov, Vladimir N. Pavlik, V. Tsyganok, A. Gramzin","doi":"10.17816/psaic1285","DOIUrl":"https://doi.org/10.17816/psaic1285","url":null,"abstract":"Spontaneous perforation of the external biliary tract is an extremely rare pathology in childhood, presented in the literature by description of clinical cases. To date, a unified approach to the treatment of children with this pathology has not been developed. \u0000The paper presents a clinical case of spontaneous perforation of the anterior wall of the common hepatic duct in a child of seven months, with the development of bilioperitoneum against the background of obstruction of the common bile duct by bilirubin calculi. \u0000CASE REPORT. The disease began acutely with repeated vomiting, stool acholia, dark urine, and an increase in the size of the abdomen in a 7-month-old child. Examination in the hospital revealed ascites, cholecystitis and shadows of calculi in the projection of the hepatoduodenal ligament. According to the results of laparocentesis, bilioperitoneum was noted. The patient underwent laparotomy, 300 ml of serous-biliary effusion was removed from the abdominal cavity. On the anterior semicircle of the common hepatic duct there is a defect from which bile flows. Suturing of the perforation of the biliary tree, cholecystectomy and drainage of the external bile ducts through the stump of the cystic duct were performed. The cholangiostomy was removed after 1.5 months. Follow-up 1 year and 3 months, pathology is not determined during the examination. \u0000CONCLUSIONS. Sewing up the site of primary perforation with drainage of the external biliary tract can help accelerate the reparative process with a decrease in the risk of developing a biliary fistula. Performing primary reconstructive interventions on the abdominal cavity compromised by bilioperitoneum, in our opinion, is too risky.","PeriodicalId":437552,"journal":{"name":"Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114188750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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