[Combined echinococcosis management in children]. / Taktika lecheniia detei s sochetannym ékhinokokkozom.

AIM: To analyze the results of diagnosis and treatment of combined echinococcosis. MATERIAL AND METHODS: The study included 51 children. 40 (78.4%) of them had combined lesion of liver and other organs, 29 - combined echinococcosis of liver and lungs. Echinococcosis of both lungs was observed in 14 children including lesion of liver in 6 cases. Combined echinococcosis of three organs was observed in 5 patients. RESULTS AND DISCUSSION: Combined echinococcosis in children was associated with uneven growth of parasitic cysts in various tissues. Small cysts were revealed in 15 (37.5%) out of 40 observations of combined lesion of liver and other organs. 7 patients underwent medical therapy for small cysts after previous surgery for medium and large cysts. Rapid growth of remained cysts occurred within 1-3 months between surgical stages. It may be often associated with complications related to remained cyst especially in case of both lungs echinococcosis. There were 6 (11.8%) postoperative complications in 51 patients with combined echinococcosis. Recurrence occurred in 2 (3.9%) children. Deaths were absent. CONCLUSION: Conservative therapy for small cysts provides 2-fold decrease of operations number and prevents recurrence of the disease. Reduced period between surgical stages up to 11±2 days prevents complications in case of both lungs echinococcosis.

[Anaesthetic maintenance with laryngeal mask for a laparoscopic surgery in pediatric patients].

UNLABELLED: Research objective was to make a comparative assessment of haemodynamics, ventilation and oxygen status and perioperative complications during laparoscopic surgeries anaesthetic maintenance with intubation and laryngeal mask use in Pediatric patients. METHODS: A retrospective observational controlled study. STUDY TERMS: from 2000 to 2012. Two groups of Pediatric patients were recruited in the study: 127 patients for general anaesthesia with laryngeal mask and 86 patients for general anaesthesia with endotracheal tube. Laparoscopy duration was 51.3 +/- 14.4 minutes. LMA-classic laryngeal mask was used. Study results showed that laryngeal mask use provided haemodynamics stability adequate ventilation and oxygen status and shorter awakening time when compared with endotracheal tube use. CONCLUSION: General anaesthesia with laryngeal mask can be used for a short laparoscopic surgery in Pediatric patients without respiratory disorders and I-II classes due to ASA physical status classification.

[Surgical management of hepatic hydatid cysts in children].

Analysis of surgical treatment of children with multiple hepatic hydatid cysts is presented. The age of patients was from 4 till 14 years. Desensibilization, hemodynamic adjustment and treatment with hepatoprotectors were used on purpose of preoperative preparation. The general anesthesia was carried out on the basis of sevofluran and propofol. Anesthesia with sevofluran has advantage. It was proved by definition of level of stress hormones. One-stage surgical management is more preferable. In case of combination with hydatid disease of lung term between the operations has made 2-3 weeks. Treatment with hepatoprotectors, enzymes, antiparasitic therapy with albendozol, physiotherapy were used in postoperative period. Postoperative complications, lethal outcomes were not observed. Relapse has been revealed at 1 (2%) patient.

[The diagnosis and surgical treatment of hydatid disease of the liver in children].

An experience with the diagnosis and surgical treatment of hydatid disease of the liver included 191 patients aged from 2 through 15 years, 26 of them had a combined involvement of the liver and lung, in 7 patients there were combined lesions with other organs. Complicated echinococcosis was noted in 25 children. Ultrasonography was given the main role in the diagnosis. Videolaparoscopic hydatidectomy of the liver was performed in 62 patients. Solitary cysts of small and medium sizes located superficially were considered as indications to operation. In patients with large and gigantic cysts of special significance was capitonnage of the residual cavity. Use of albendazole as an antiparasitic agent for the recurrent disease and a prophylactic agent after operation for multiple and combined hydatid disease of the liver was found to be sufficiently effective.