[Radical surgical correction of anorectal anomalies in children by the method of posterior sagittal anorectoplasty]. / Radikal'naia khirurgicheskaia korrektsiia anorektal'nykh anomalii u detei metodom zadnei sagittal'noi anorektoplastiki.

In the period from 1987 to 1991, radical operations by the method of posterior sagittal anorectoplasty were conducted on 29 children with anorectal anomalies, whose ages ranged from zero to 10 years. In this group 12 patients were under the age of six months. The diagnosis was based on the presence of external clinical signs of the anomaly, ultrasonic scanning of the organs of the chest, abdomen, and true pelvis, as well as on the findings of the generally accepted radiological methods. In 23 children the radical operation was preceded by colostomy. Hyperbaric oxygenation was applied in the postoperative period in all patients. The late-term results were studied in 17 patients, they were found to be good in 12 patients and satisfactory in one patient. Mortality was not encountered in this group of patients.

[The treatment of acute esophagogastric hemorrhage in the portal hypertension syndrome in children]. / Lechenie ostrogo pishchevodno-zheludochnogo krovotecheniia pri sindrome portal'noi gipertenzii u detei.

Twenty-eight children were treated in the clinic for acute gastro-esophageal bleeding in portal hypertension syndrome. Conservative therapy has proved to be effective in 85.8% of cases. Endoscopic sclerotherapy was successfully used in 9 of the 11 patients. In ineffective conservative treatment for 24-48 hrs from the onset of bleeding, the authors consider suturing the esophago-gastric junction with ligation of the gastric vein and blocking the arterial splenic blood flow as an operation of choice.

[Effect of hyperbaric oxygenation on normalization of intestinal function after surgical treatment of Hirschsprung disease and anorectal developmental defects in children]. / Vliianie giperbaricheskoi oksigenatsii na normalizatsiiu funktsii kishechnika posle operatsii po povodu bolezni Girshprunga i anorektal'nykh porokov razvitiia u detei.

Performed were 264 procedures of hyperbaric oxygenation (HBO) in 93 children operated on for Hirschsprung's disease and anorectal developmental defects. The positive effect of HBO on the main links of pathogenesis of many postoperative complications caused by general and local hypoxia was noted. HBO contributes to improvement in viability of the intestinal wall, stabilizes intestinal peristalsis, decreases retention of liquid in the stomach and likelihood of the anaerobic infection development. Performance of hyperbaric oxygenation in combination with the conventional principles of postoperative therapy permits to shorten the duration of the use of parenteral nutrition, decrease a frequency of purulent-septic complications.

[Survival of patients after combined treatment for rectal cancer]. / Vyzhivaemost' bol'nykh posle kombinirovannogo lecheniia po povodu raka priamoi kishki.

The analysis of end results of treatment of rectal cancer showed combined therapy to assure long survival in the whole group of radically operated cases, viz. two-third of them survived 10 years. Conversely, mean survival of non-operated or surgically palliated patients was as low as 10.1 and 26.7 months, respectively. Survival of radically operated cases was found to be related to various clinico-anatomic factors, the most close relationship being observed for extent, histology and growth pattern of tumor and regional nodal status. The influence of site and surgical procedure on patient survival proved far less significant.

[Diagnosis and treatment of biliary tract obstruction in children with biliary atresia]. / Diagnostika i lechenie narushenii prokhodimosti zhelchevyvodiash- chikh putei pri porokakh razvitiia u mladentsov.

Fifty children from one month to 14 years of age were examined and subjected to surgical treatment. Atresia of the bile ducts was diagnosed in 34 of them, hypoplasia of the bile ducts in 5, and a cyst of the choledochus in 11. Biliary atresia was managed by different variants of portoenterostomy, mostly after Kasai I, and two operations of cholecystojejunostomy were conducted in the so-called correctable type of atresia. 5 patients with biliary hypoplasia were treated by cholecystectomy, lavage of the bile ducts, and denervation of the hepatic artery. The following operations were carried out on 11 patients with a cyst of the choledochus: extirpation of the cyst with subsequent hepaticojejunostomy in 4, cystojejunostomy in 5, and cystoduodenostomy in 2 patients. Ultrasonic examination of the liver was undertaken in all 50 patients with impaired patency of the biliary tract as a screening test. Nine patients died in the postoperative period.

[Diagnosis and surgical treatment of common bile duct cysts in children]. / Diagnostika i khirurgicheskoe lechenie kist obshchego zhelchnogo protoka u detei.

The authors treated 11 children at the age of from 2 mos to 14 yrs with the common bile duct cysts. The common bile duct cyst extirpation with the hepatico-jejunoanastomosis formation is considered an operation of choice.

[Rectal myectomy in the treatment of chronic constipation in children]. / Rektal'naia miéktomiia pri lechenii khronicheskogo zapora u detei.

Rectal myectomy was used with the positive result in 22 children. In patients with the supra-anal form of the Hirschsprung's disease, rectal myectomy was performed as an independent intervention. In patients with the residual zone of agangliosis after radical intervention, idiopathic constipation after radical myectomy, the pressure in the anal canal reduced, rectal emptying improved.

[Diagnosis and treatment of esophageal achalasia in children]. / Diagnostika i lechenie akhalazii pishchevoda u detei.

The article shows the results of diagnosis and treatment of achalasia of the esophagus in 21 children aged from 20 months to 15 years. Radiological examination with the use of the nitroglycerin test was highly informative and authentic in all cases. To evaluate the condition of the esophagus, additional endoscopic and esophagomanometric examination is necessary. From analysis of the results of drug therapy in all patients, operative in 13, and pneumocardiodilatation in 7 children it was found that treatment of achalasia of the esophagus in children should begin with forced pneumodilatation. Modified Heller's operation with fundoplication produces good results.

[Diagnosis and treatment of Hirschsprung disease in young children]. / Diagnostika i lechenie bolezni Girshprunga u detei rannego vozrasta.

The diagnostic value of instrumental methods of examination and the results of surgical treatment were studied in 56 patients under 3 years of age with Hirschsprung's disease. Complex examination (irrigography, anomanometry, histochemical and neurohistological studies) allows the disease to the diagnosed early and operative treatment to be undertaken in time. Colostomy is the operation of choice for infants. Operation for downward transposition of the colon with primary anastomosis produces better results in older children.

[Enteral-tube feeding with cozylate of patients with malignant neoplasms in the early postoperative period following surgical interventions on the abdominal organs]. / Enteral'no-zondovoe pitanie kozilatom bol'nykh so zlokachestvennymi novoobrazovaniiami v rannem posleoperatsionnom periode posle khirurgicheskikh vemeshatel'stv na organakh briushnoi polosti.

The authors present clinical results of enteral cozylate tube feeding diet in patients with malignant tumors following abdominal surgical interventions. They found a good tolerance to the drug, rapid recovery of gastrointestinal motility, lack of complications due to cozylate application.

[Radiotherapy in the combined treatment of cancer of the rectum]. / Luchevaia terapiia v kombinirovannom lechenii raka priamoi kishki.

Analysis of the results of two methods used in the treatment of operable carcinoma of the rectum showed the advantages of the combined method over the purely surgical method: the survival of patients after combined treatment was practically twice that among patients subjected only to operation. No essential differences were found in the character and incidence of postoperative complications and postoperative lethality. All this allows the combined method of treatment to be recommended for wide use in clinical practice.

[Combination treatment of rectal cancer using preoperative combination radiotherapy]. / Kombinirovannoe lechenie raka priamoi kishki s predoperatsionnoi sochetannoi luchevoi terapiei.

The paper is concerned with analysis of the results of therapy of 122 rectal cancer patients divided into 2 groups by sex, age, tumor site, type of anatomical tumor growth, and stage of disease: I (72 patients)--combined therapy including preoperative radiotherapy and operation; II (50 patients)--surgery alone. Indications for combined therapy with preoperative irradiation were worked out. The results of histological investigation showed that this method brought about deep radiation injuries of tumors with minimum damage of the adjacent normal tissues. A conclusion was made that combined therapy including preoperative irradiation decreased the number of recurrences and metastases and increased (in combination with surgical intervention) the 5-year survival rate up to 79.6%.