[Interintestinal anastomoses formation using permanent magnet in surgical treatment of children with intestinal stomas].

It was analyzed the results of treatment of 48 children aged from 1 month to 14 years. In these observations by the 6th - 7th days after doubleintestinalstoma formation magnetic dies with inductance from 300 to 360 mTl and energy force at least 255 kJ/m3 were introduced into lumen of afferent and efferent intestinal loops. Attractive or compression force between dies was 600 g, i.e. force per 1 cm2 was 200 g according to dies' surface 1.12.83.0 cm. Magnets are not only surgical instruments but also physiotherapeutic devices improving microcirculation and stimulating regeneration in the area of anastomosis. Interintestinal anastomosis has been completely formed for 5-7 days. Thereafter magnetic dies have been removed. Stool was normalized in 45 of 48 observations after surgery (1-3 times daily). Intestinal discharge from ileostomy reduced to minimal amount. In 2 patients irregular bowel movements was observed due to adhesive stenosis of interintestinal anastomosis. Magnetic dies can't be established in 1 case due to adhesive process. Hospital stay was from 10 to 25 days in 41 children. 7 patients were discharged for outpatient treatment later. All children were under observation for the period 2-4 months after discharge. Signs of hypotrophy including body weight deficit within 10% of age norm were diagnosed only in 3 children with prematurity degree I-II. Hereafter children were repeatedly hospitalized; intestinal stomas were surgically removed using conventional technique. Thus complete convalescence was obtained.

[Short bowel syndrome in children: etiology and basic approaches to treatment].

The paper considers the main causes and clinical manifestations of the short bowel syndrome in children, defines the clinical and physiological features of the disease in children. The world experience in managing patients with short bowel syndrome is summed up. Indications for total parenteral or parenteral-and-enteral feeding in relation to the site of intestinal resection are analyzed. Artificial therapeutic feeding is shown to play the leading role in the complex of rehabilitation of children with short bowel syndrome.

[The current methods for the prevention, diagnosis and surgical treatment of the adhesive complications of peritonitis in children]. / Sovremennye metody profilaktiki, diagnostiki i khirurgicheskogo lecheniia spaechnykh oslozhnenii peritonita u detei.

The paper is based on clinical and experimental findings of one of the postoperative complications of purulent peritonitis, namely adhesion formation. The authors consider that impaired cytodynamic relationship in the focus of peritonitis concurrent with gastrointestinal paresis underlie the pathogenesis of the above-mentioned complication. In this connection, the authors propose a set of anti-adhesive measures, which involves prodigiosane cytomodulation and differential treatment of enteroparesis. Intestinal ultrasonic echocardiography was used for diagnostic purposes. Laparoscopy was employed in the surgical treatment of adhesive complications of peritonitis, which allowed relaparotomy to be eliminated or its traumaticity to be reduced to a great extent. There were no deaths and relapses of adhesive disease.

[Surgical treatment of appendicular peritonitis in children]. / Khirurgicheskoe lechenie appendikuliarnogo peritonita u detei.

The article is based on the results of 10-year use of the method of aspiration drainage of the abdominal cavity in the treatment of 980 children with purulent peritonitis of appendicular origin. The authors used only a polymer tube to drain the cavity of the true pelvis and in principle did not resort to intraoperative irrigation of the abdominal cavity, postoperative lavage, and intraperitoneal injection of antibiotics. Postoperative complications were recognized in the early stages of development and were treated by nonoperative methods on the main. The number of relaparotomies was 0.83% of the total number of operations for appendectomy. The described method meets the principles of pediatric surgery most fully, is more sparing than the other methods, and the authors recommend it for wide introduction into practice.

[The diagnosis of motor disorders of the small intestine in peritonitis in children and the rationale for pathogenetic methods of correction]. / Diagnostika dvigatel'nykh narushenii tonkoi kishki pri peritonite u detei i obosnovanie patogeneticheskikh metodov korrektsii.

The work deals with the results of experimental (200 animals) and clinical (20 patients) study into the role of the efferent link of the autonomic nervous system in regulating motor activity of the small intestine and the possibility of using direct electroenteromyography in the diagnosis of the stages of paresis and the degree of motor disorders in peritonitis. The pathogenetic methods of treatment of intestinal paresis are substantiated. Medicamentous stimulation of the cholinergic nervous system in peritonitis is effective only when intactness of the intramural ganglia is maintained, in which case the electroenteromyographic test with neostigmine methylsulfate or cerucal may be conducted. The pathogenetic method of treatment in all other cases is medicamentous blockade of the adrenergic nervous system.

[Prophylaxis, diagnosis and surgical treatment of adhesions in the abdominal cavity of children]. / Profilaktika, diagnostika i khirurgicheskoe lechenie spaechnogo protsessa briushnoi polosti u detei.

The clinical and experimental study of postoperative complications of suppurative peritonitis (the pathologic commissure formation) has been done. The authors believe that the combination of the break of cytodynamic correlation in peritonitis centre and GIT paresis is a basis of pathogenesis of the process. The authors advocate combination of anticomissural preventive stern with cytomodulation and GIT paresis treatment. The abdominal ultrasonography has been used for the diagnosis. The main role in surgical treatment belongs to laparoscopy that made it possible to decrease the amount of relaparotomy cases. There were no lethal complications or cases of recurrency.

[Ultrasonic diagnosis of limited forms of appendicular peritonitis in children]. / Ekhografiia v diagnostike otgranichennykh form appendikuliarnogo peritonita u detei.

Results of an analysis of echographic diagnostics of appendicular peritonitis in 60 children have shown its high informative value. Under consideration are problems of the rational technique of investigation depending on localization of the pathological focus. Differential diagnostic criteria of various forms of limited peritonitis in children are presented. Possibilities of the method to establish the objective efficiency of the therapeutic treatment and substantiation of tactics of the treatment are shown.