[Surgical treatment of developmental anomalies of the gallbladder and chronic cholecystitis in children]. / Khirurgicheskoe lechenie anomalii razvitiia zhelchnogo puzyria i khronicheskogo kholetsistita u detei.

The authors report on the diagnosis, therapeutic tactics, the results of morphological studies, and the late-term results of surgery for developmental anomalies of the gallbladder and chronic cholecystitis with organic disorders of bile drainage in 53 children aged from 5 to 15 years. The findings of morphological studies showed that among the causes of impaired bile drainage developmental anomalies of the gallbladder were encountered much more frequently than chronic cholecystitis. Indications for operation were developed on the basis of clinical data and the results of auxiliary methods of examination. Clinical, radiological, and morphological comparisons showed these indications to be well-founded. The immediate and late-term results of surgical management of developmental anomalies of the gallbladder and chronic cholecystitis with organic disorders of bile drainage confirm the expediency of active surgical tactics in the presence of the proper indications.

[Dislocation of both forearm bones complicated by rupture of the internal epicondyle with its incarceration in the articular cavity in children]. / Vyvikh obeikh kostei predplech'ia, oslozhnennym otryvom vnutrennego nadmyshchelka s ushchemleniem ego v polosti sustava, u detei.

An analysis of the clinical picture of dislocation of both forearm bones complicated by abruption of the internal epicondyle with strangulation of it in the articulation cavity in 46 children is given. A method of open reposition of the fragment is described on the basis of many-years experience of treatment of dislocation fractures in the area of elbow joint. Long-term results of treatment were studied in 38 patients during 1-21 years. In 33 of them good results were noted.

[Infiltrative subacute omentitis in children with acute appendicitis]. / Infil'trativnyi podostryi omentit pri ostrom appenditsite u detei.

Results of treatment of 87 children with infiltrative subacute omentitis (ISO) which appeared after operation for acute appendicitis are described. ISO has its clinical and morphological picture, can be complicated by comissural obstruction of the intestine (27 patients) or abscess formation (10 patients). It was observed in acute appendicitis in 0.18% of the cases, after appendicular peritonitis--in 2.8%. The operation of choice in infiltrative omentitis is supposed to be a removal of the greater omentis, in abscessing omentitis--resection of the omentum. Two patients with ISO developed after appendicular peritonitis died.

[The cleft sternum]. / Rasshcheplenie grudiny.

An analysis of 14 patients with cleft sternum is presented. Eleven patients were operated upon. A classification of this defect is proposed. The clinical picture of each type of cleft sternum is given with a description of the operative technique. There were no lethal outcomes. Remote results were good.

[The treatment of newborns with gastroschisis]. / Lechenie novorozhdennykh s gastroshizisom.

Gastroschisis is considered by the authors to be an embryopathy. The main principles of management of newborns with gastroschisis are: warming of the newborn, rehydration, measures against pseudoobstruction of the intestine. An effective method which could be recommended for all kinds of operations for defects of the anterior abdominal wall is a "manual enlargement of the abdominal cavity" during operation.

[Fracture of the ulna with dislocation of the radius in children]. / Perelom loktevoi kosti s vyvikhom luchevoi kosti u detei.

Based on an analysis of observations of 85 children the authors discuss questions of diagnostics and tactics of treatment of different kinds of fractures of the elbow bone with dislocation of the radius. The authors obtained good results of treatment.

[Surgical treatment of hernia of the esophageal foramen of the diaphragm in children]. / Khirurgicheskoe lechenie pri gryzhe pishchevodnogo otverstiia diafragmy u detei.

The surgical treatment of hernia of the esophageal foramen of the diaphragm was performed in 57 children. The transabdominal access was used in operations in 6 of these 57 patients (4 of them had recurrent hernias). In 51 children operations were fulfilled by the transthoracic way. No recurrencies were noted. Good remote results were obtained in 30 patients observed.

[Keeled chest]. / Kilevidnaia deformatsiia grudnoi kletki.

The authors analyze their observation of 66 patients with pigeon-breast deformity, 42 of them were operated upon. They propose a classification of the pigeon breast deformity on the basis of anatomo-physiological and clinical principles. Techniques for the operative correction of each type are proposed. Good cosmetic and functional results were obtained.

[Paraesophageal hiatal hernias in children]. / Paraezofageal'nye gryzhi pishchevodnogo otverstiia diafragmy u detei.

Two main types of the clinical course of the disease were distinguished on the basis of the examination of great clinical material. They are the chronic course and incarcerated hernias. The clinical picture and treatment of children with paraesophageal hiatal hernias are described in detail. Main roentgenological features of the malformation are shown in association with the clinical course of the disease.

[Surgical treatment in Poland's syndrome in children]. / Khirurgicheskoe lechenie pri sindrome Polanda u detei.

An experience with treatment of 16 patients with the Poland syndrome has been analyzed, 12 of them had been operated upon. An interpretation of the disease as a defect and deformity is proposed. The clinical picture of the variants of the Poland syndrome is describes. The authors give a description of the preoperative preparation, postoperative management and a technique of the operative liquidation of all the symptoms of the defect. There were no lethal outcomes. An analysis of long-term results is given.

[Surgical treatment of a central (sliding) hernia of the esophageal opening of the diaphragm in children]. / Khirurgicheskoe lechenie tsentral'noi (skol'ziashchei) gryzhi pishchevodnogo otverstiia diafragmy u detei.

For 25 years in the clinic there were 21 children surgically treated for the central (sliding) hernia of the esophageal opening of the diaphragm. No recurrences were noted in the postoperative period. Two patients were additionally subjected to surgical procedures in order to liquidate esophageal stenosis. Remote results of the treatment were good. After operation the opening and closing of the cardia were normal. No gastroesophageal reflux was noted. The patients were practically healthy.

[Treatment of intestinal paresis in children]. / Lechenie pareza kishechnika u detei

In the paper, a clinical experience with treatment of intestinal paresis in 545 children, aged from 1 day to 13 years, including 225 children operated upon for peritonitis is summarized. The authors differentiate 3 stages in the development of intestinal paresis depending on the degree of intensity of systemic and local disturbances. The employed methods of treatment in intestinal paresis were classified by the principle of their effect as 3 groups. Application of some or other method of the paresis therapy is determined by the stage of its development. In treatment of postoperative intestinal paresis a continuous peridural blockade is considered to be the method of choice. Utilization of the latter enabled the authors to reveal a number of postoperative complications: mechanic intestinal obstruction, incompetent anastomosis, etc.

[Intestinal obstruction in children caused by congenital adhesions and fibrous cords]. / Neprokhodimost' kishechnika u detei na pochve vrozhdennykh spaek i tiazhei

The authors present an analysis of 36 observations of congenital adhesive intestinal obstruction in children aged from 1 day to 11 years. In newborn infants and small children, aged from 1 to 3 years, the disease was mostly manifested in the clinic of acute obstruction. Therefore, all these children were operated upon on urgent indications. An importance of restoration of the bowel function as early as possible is emphasized for prophylaxis of the adhesive process. Postoperatively, physical therapy and prolonged peridural anesthesia are widely advocated. No recurrence of adhesive intestinal obstruction was noted.

[Results of diverting the urine into the intestines in bladder exstrophy in children]. / Rezul'taty otvedeniia mochi v kishechnik pri ékstrofii mochevogo puzyria u detei.

An analysis of immediate and long-term results of urine elimination into the intestine in exstrophy of the urinary bladder in 100 children has shown sigmocystoanastomosis to be the optimal method which reliably restores continence of urine and prevents the development of urinary infection and pyelonephritis.

[Surgical treatment of rupture of the epicondyle in dislocation of both forearm bones in children]. / Khirurgicheskoe lechenie otryva nadmyshchelkov pri vyvikhe obeikh kostei predplech'ia u detei.

Results of the surgical treatment of abruption of epicondyles in dislocation of both forearm bones in 86 children aged 9-14 are described. Long-term results of the treatment were studied in 63 patients within the period from 1 till 21 years. In most patients excellent and good anatomical and functional results were obtained.

[Percutaneous short-term metal osteosynthesis of epicondylar fractures in dislocations of both forearm bones in children]. / Chreskozhnyi kratkovremennyi metalloosteosintez otryva nadmyshchelkov pri vyviknakh obeikh kostei predplech'ia u detei.

Clinico-roentgenological signs of dislocations of both forearm bones complicated by abruption of epicondyles were diagnosed in 260 children. Indications for closed percutaneous short-term metallic osteosynthesis were developed and used in 76 patients (29.23%). Indications for percutaneous metallic osteosynthesis were as follows: 1) displacement of a fragment in the sagittal, frontal plane or to below more than 5 mm and rotation of the fragment more than 30 degrees (in 41 patients); 2) failure of closed reposition (in 21 patients); 3) vast hematomas, edemas of soft tissues (14 patients).

[Chronic acalculous cholecystitis in children]. / Khronicheskii beskamennyi kholetsistit u detei.

Based upon literature data and an analysis of immediate and remote results of treatment of 50 children with acalculous cholecystitis the authors point to the advisability of operative interventions in patients with organic disturbances of the bile outflow. An analysis of the clinical picture, effects of the conservative therapy and results of subsidiary investigations enabled the authors to establish indications to surgery. The surgical methods must be determined by the character of pathology of the gallbladder, bile ducts and concomitant diseases. The immediate and long-term results of the surgical treatment of chronic cholecystitis resulting from organic disturbances of bile excretion confirm expediency of active surgical tactics in the presence of indications and of strict dispensary observation after operations for this disease.

[Esophagocele with elevated esophagus in children]. / Ezofageal'naia gryzha s pripodniatym pishchevodom u detei.

The clinics of the Department of Surgery in Children of the Leningrad Pediatric Medical Institute during the period of 1951-1983 dealt with 29 children aged from some days to 9 years with hiatal hernias and the elevated esophagus. Results of the observation of patients with hiatal hernia and elevated esophagus have shown the clinical manifestations of the disease to be various. They can be divided into 4 clinical groups: 1) acute course, 2) subacute course, 3) incarcerated hernias, 4) asymptomatic course.

[Ectopia cordia]. / Ektopiia serdtsa.

9 children aged from 40 hours to 7 years were operated upon. The peculiarity of the surgical intervention in a newborn consists in the difficult arising at the correction of the position of the heart. Both newborns died to the heart defects incompatible with life. The operations carried out upon elder children (7) were successful, the difficulty derived from the necessity to form a thoracic frame over the transposed heart. The late results are good.

[Congenital cystic transformation of the common bile duct in children]. / Vrozhdennaia kistoznaia transformatsiia obshchego zhelchnogo protoka u detei.

By now the world literature counts 955 observations on congenital cystic enlargement of the common bile duct. The authors add 14 own observations of this rather rare pathology. Preoperative diagnosis is still difficult. The intravenous cholegraphy remains the best diagnostic procedure. The choledochocystoduodenostomy is justified by its usefulness and is the most frequently used. The late results of the treatment are good. An unfavourable prognosis is present only in cases with preoperative chronic hepatitis, cholangitis or pancreatitis, as these diseases are likely to aggravate later on.