THERAPEUTIC APPROACH IN RECURRENT INTUSSUSCEPTION OF BOWELS IN CHILDREN.

An analysis of treatment results was made in 216 patients with intussusception of bowels at the period from 2000 to 2015. The authors showed that it would be reasonable to carry out a conservative therapy in the cases of recurrent intussusception in absence of peritonitis symptoms.

[Diagnostics and treatment of congenital malformations of the lung and mediastinum in newborn children and infants].

The article presents the experience of treatment of newborn children and infants with congenital malformations of the lung and mediastinum, which required a surgery. Children (138 cases) were treated during recent 18 years. There was a prevalence of full-term infants (73%). Fetal malformations were diagnosed in prenatal period in majority of cases. Computed tomography was the main method of diagnostics after delivery. Children (110 cases) were operated out of 138. Children with extrapulmonary sequestration didn't undergo surgery in case of absence of clinical manifestations. The authors made a conclusion that malformations of the lung and mediastinum should be included in number of differentiated diseases in case of respiratory distress syndrome in newborn children. The indications to early surgery should be the danger of contamination and malignant transformation, presence of intrathoracic tension syndrome in neonatal period.

[Features of clinical course of primary peritonitis in children].

The article presents an analysis of the features of primary peritonitis in children. Medical reports of 182 patients with primary and appendicular peritonitis were analyzed. It was significant, that the sick girls aged 4-7 years often had the primary peritonitis after acute inflammatory processes, which took place a month earlier. Chronic infection foci were noted in these patients. The age-specific features of maturation of the immune and reproductive systems predisposed the disease.

[Polyenzymatic therapy in prevention of adhesive processes in the abdominal cavity in children].

The clinical investigation included 48 patients with acute adhesive intestinal obstruction resulting from appendectomy and an analysis of the cytokine status in 34 children with acute phlegmonous appendicitis. The patients were divided into two groups: a "polyenzyme" group and a "monoenzyme" group (Hyaluronidase). In the "polyenzyme" group the children were given the preparation Wobenzym in addition to the complex therapy, in the "monoenzyme" group--electrophoresis of Hyaluronidase. In the "monoenzyme" group there were 2 cases of intestinal obstruction. The patients from the "polyenzyme" group had no postoperative complications. Wobenzym was shown to reduce (p < 0.05) the level of pro-inflammatory cytokines (IL-2, IL-6, TNF-alpha) and to increase the level of anti-inflammatory cytokine (IL-4). Using the polyenzyme preparations after abdominal operations in children was found to promote the reduction of intra-abdominal adhesion and inflammatory processes.

[The history of the surgery of esophageal atresia (based on data from the Saint-Petersburg Center for Neonatal Surgery)]. / Istoriia khirurgii atrezii pishchevoda (po materialam Sankt-Peterburgskogo tsentra khirurgii novorozhdennykh).

The article presents 42-year experiences with surgical treatment of atresia of the esophagus in 814 neonatals in the St. Petersburg Center of surgery in neonatals. Under analysis are the consecutive periods of work in this field, development and introduction into practice of the methods of surgical interventions, the original Bairov's operation--double esophagostomy--included. Factors responsible for results of the treatment of esophageal atresia are described. Improvement of the methods of treatment has resulted in a possibility mainly to make anastomoses of the esophagus and reduce lethality of neonatals with esophageal atresia from 81 to 7.7%.

[First experience with the surgical treatment of young infants with congenital pathology of the locomotor system]. / Pervyi opyt khirurgicheskogo lecheniia detei rannego vozrasta s vrozhdennoi patologiei oporno-dvigatel'nogo apparata.

The authors have revised traditional principles of treatment of children with a congenital pathology of the locomotor system. Early treatment has been shown to be necessary beginning from infancy since the operations have a more favourable course. Normal anatomo-physiological correlations of the locomotor system are being formed from the early days and months of the infants. Good immediate results were obtained in 22 children. The authors recommend to establish terms of the operative interventions for orthopedic abnormalities immediately after birth in the maternity home.

[Methods of surgical treatment of Hirschsprung's disease in newborns]. / Khirurgicheskaia taktika pri bolezni Girshprunga u novorozhdennykh.

Fifty-nine newborn infants with Hirschsprung's disease were treated at the Saint-Petersburg Center of Surgery of Developmental Anomalies from 1978 to 1991. The typical rectosigmoid form was found in 47.5% and a long zone of agangliosis in 35.6% of children. Mortality rate--16.7%. According to the development of enterocolitis, three variants of the course of the disease in the newborns were distinguished. It is shown that the informativeness of the diagnostic methods increases with the growth of the infants, and the final diagnosis of Hirschsprung's disease is best established at the age of over two weeks on the basis of repeated or initially postponed contrast study of the large intestine. Inefficacy of nonoperative treatment conducted for 2-3 days and recurrence of symptoms of intestinal obstruction are indications for operative decompression of the intestine. The performance of one-stage radical operation at the age of about one month is advisable in an uncomplicated course of the disease.

[Late results of the surgical treatment of hiatal hernia in children]. / Otdalennye rezul'taty operativnogo lecheniia gryzhi pishchevodnogo otverstiia diafragmy u detei.

The operative treatment of 46 children has shown that favorable long-term results were obtained due to early detection and radical treatment of the defect. The pathological changes of the esophagus and stomach mucosa gradually disappeared.

[T-shaped anastomosis in treating acute intestinal obstruction in newborn infants]. / T-obraznyi anastomoz v lechenii ostroi kishechnoi neprokhodimosti u novorozhdennykh.

Newborns with the ileus caused by developmental defects of the digestive tract have, as a rule, suprastenotic dilatations of all the intestine or a considerable part of it higher than the ileus zone and a great difference in the width of the lumen of the intestine portions left after resection of the injured area. In the Center of Developmental Defects of Newborns 190 patients with ileus have been treated for the recent 10 years. In 37 cases T-shaped bypass anastomosis was used which has considerable advantages over "dead" anastomosis. T-shaped ileostomy allows unloading the dilated adducting part of the intestine overfilled with the contents in early terms after operation and simultaneously fulfilling "the feeding" into the abducting part of the intestine.