Paediatric Surgery. Ukraine最新文献

{"title":"Endovascular procedures at the complex management in patients with portal hypertension and variceal bleeding","authors":"V. Petrushenko, O. O. Kedyk","doi":"10.15574/ps.2023.80.66","DOIUrl":"https://doi.org/10.15574/ps.2023.80.66","url":null,"abstract":"For today, endovascular procedures, such as embolization of splenic artery, transjugular intrahepatic shunt, and retrograde transvenous obliteration with balloon occlusion are widely applied in the treatment and prophylaxis of variceal bleeding in patients with portal hypertension. Splenomegaly with the development of hypersplenism is one of complications of portal hypertension in patients with liver cirrhosis, which can negatively be influenced on clinical course. Due to that, it can be assumed that the management of hypersplenism in patients with portal hypertension with the applying of splenic artery embolization, could be improve the results of treatment of this group of patients. Purpose - to summarize the own experience of the applying of splenic artery embolization in the complex therapy in patients with portal hypertension that complicated by the variceal bleeding. Materials and methods. This study based on the results of treatment of 36 patients, in which the embolization of splenic artery was applied in the complex management (conventional treatment and endoscopic ligation of varices). The classic method of “chronic” occlusion was used for the embolization. The embolization on the level of the initial portion of the main trunk of splenic artery was performed in 30 (83.3%) of patients. Due to the anatomical peculiarities of vasculature, embolization was performed on the level of middle part of splenic artery in 6 (16.7%) of patients. The effectiveness of the treatment was evaluated by the changes of complete blood count indices and ultrasonography results. Statistical analysis was performed using the program SPSS Statistic for Windows, version 15.0 (IBM Corp., Armonk, NY, USA). Results. The middle age of patients was 55.8±1.6 years. The middle value of Child-Turcotte-Pugh criterion was 2.44±0.08, and MELD score was 16.36±0.99 value. Conclusions. The applying of splenic artery embolization that combined with conventional therapy and endoscopic ligation of varices is appropriate and justified. Embolization of the splenic artery promotes to decrease of appearance of hypersplenism in patients with the portal hypertension with positive influence on follow-up clinical course. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.","PeriodicalId":166002,"journal":{"name":"Paediatric Surgery. Ukraine","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139335057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical treatment of arachnoid cysts in the middle cranial fossa in children","authors":"O.M. Molodetskyi","doi":"10.15574/ps.2023.80.27","DOIUrl":"https://doi.org/10.15574/ps.2023.80.27","url":null,"abstract":"Intracranial arachnoid cysts (ACs) are benign lesions that are usually incidental findings but can cause neurological symptoms due to the mass effect if they grow. The choice of the optimal surgical treatment for middle cranial fossa (MCF) ACs is still controversial. Such options include neuroendoscopic cystic cisternostomy, microsurgical cystic cisternostomy, cystoperitoneal shunting. Purpose - to conduct a comparative analysis of surgical techniques for the treatment of ACs in MCF; to analyze the results of surgical treatment of ACs in MCF. Materials and methods. Clinical and instrumental results and anamnesis data of all paediatric patients with ACs in MCF who underwent surgical treatment at the SI «Romodanov Institute of Neurosurgery of the NAMS of Ukraine» in 2016-2021 (19 cases) were analysed. 19 patients were selected, 10 of whom were operated on endoscopically, 3 - microsurgically, 6 - underwent cystoperitoneal bypass. Results. Improvement of the condition or disappearance of symptoms was observed in 9 (90%) out of 10 patients who underwent endoscopic surgery, in 2 (63%) out of 3 patients who were treated with microsurgery, in 6 (100%) out of 6 patients who underwent surgical treatment by gastric bypass. The frequency of repeated surgical interventions in the case of primary surgery by endoscopic method was on average 0.5 operations per 1 case, microsurgical method - on average 0.3 operations per 1 case, bypass surgery - on average 2 operations per 1 case. The length of stay in the hospital after surgery was: for patients undergoing bypass surgery - from 14 to 47 days (average - 24 days); for patients undergoing microsurgery - from 7 to 25 days (average - 13 days); for patients undergoing endoscopic surgery - from 7 to 10 days (average - 8 days). Conclusions. All surgical techniques are effective in the treatment of symptomatic ACs in MCF. Endoscopic treatment of symptomatic ACs in MCF allows to achieve a stable regression of clinical manifestations of the disease with a minimal likelihood of reoperation. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the author.","PeriodicalId":166002,"journal":{"name":"Paediatric Surgery. Ukraine","volume":"237 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139335115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of the stress-deformed state of the chest during the correction of the funnel-shaped deformity with the use of two plates: a comparison of the parallel and crossed methods of placing the fixators","authors":"V. Pylypko, A. Levytskyi, M. Karpinsky, O.D. Karpinska, O. Yaresko","doi":"10.15574/ps.2023.80.40","DOIUrl":"https://doi.org/10.15574/ps.2023.80.40","url":null,"abstract":"Minimally invasive correction of funnel-shaped chest deformity by the Nuss is an effective and cosmetic method of surgical correction of this deformity. Some authors have proposed the use of two plates with a crossed technique for correction. Purpose - to study the changes that occur in the stressed-deformed state of the chest model in comparison of the parallel crossed arrangement of the fixators during the minimally invasive correction of funnel-shaped chest deformity according to Nuss. Materials and methods. 2 schemes for the correction of the funnel-shaped deformation of the sternum were modeled: with a parallel arrangement of plates (parallel method), with a cross-shaped arrangement of plates (crossed method). The models were loaded with a distributed force of 100 N applied to the sternum. They studied the stress values in the bone elements, the relative deformations of costal cartilage, as the softest and, as a result, the most favorable to deformation element of the models. The magnitudes of the maximum movements of the sternum and corrective plates were also studied as an indicator of the preservation of the achieved correction. Results. The crossed method of positioning the corrective plates ensures a slightly lower level of stress in almost all bone elements. An exception can be considered the seventh ribs, where the stress, in this case, reaches 9.0 MPa, which is close to the lower limit of the indicators of the strength limit of the ribs. From the point of view of preserving deformation correction, the crossed method of arranging the correcting plates has a slight advantage of 1.0 mm. But the parallel scheme provides a smaller relative deformation of the costal cartilages. Taking into account all of the above, it can be concluded that none of the studied schemes has an unequivocal advantage over the other according to the criteria of mechanical indicators. Therefore, when choosing one or another scheme for the correction of a funnel-shaped sternum deformity, additional information should be taken into account, such as the shape of the sternum deformity and the rib, the convenience of carrying out the plates, the age of the patient, etc. Conclusions. None of the studied schemes has an unequivocal advantage over the other according to the criteria of mechanical indicators. From the point of view of preserving deformation correction, the crossed method of arranging the correcting plates has a slight advantage of 1.0 mm. The parallel scheme ensures a smaller relative deformation of the costal cartilages. According to the criterion of stress distribution in the bone elements of the model, the crossed method of arranging the corrective plates provides a slightly lower level in almost all bone elements, but the maximum stress value of 9.0 MPa on the seventh rib with the cross-shaped arrangement of the corrective plates approaches the lower limit of the index of the strength limit of the ribs which, in some cases, can cause its fracture. Addi","PeriodicalId":166002,"journal":{"name":"Paediatric Surgery. Ukraine","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139335078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and potentiometric examinations of adolescent patients with chronic odontogenic maxillary sinusitis in the presence of galvanic pathology in the oral cavity","authors":"O. Tymofieiev, A.M. Cherednichenko","doi":"10.15574/ps.2023.80.35","DOIUrl":"https://doi.org/10.15574/ps.2023.80.35","url":null,"abstract":"Purpose - to determine the values of potentiometric parameters in the oral cavity present between metal inclusions, as well as between metal inclusions and the mucous membrane of the alveolar ridge in adolescent patients with chronic odontogenic maxillary sinusitis in the presence of galvanic pathology in the oral cavity Materials and methods. 30 patients with chronic odontogenic maxillary which were subjected to potentiometric and general clinical examination methods. The control group consisted of 22 practically healthy people (without concomitant diseases) of the same age, but without metal inclusions in the oral cavity (amalgam fillings and metal fixed dentures) with obligatory sanitized oral cavity. All numerical data obtained during the survey were processed by mathematical method with calculation of Student's criterion. The indicators were considered reliable at p<0.05. Results. In 30 patients with chronic odontogenic maxillary sinusitis with the presence of galvanism (compensated and decompensated forms) in the oral cavity, chronic inflammation in the maxillary sinus occurred without pronounced clinical symptoms. Conclusions. In adolescent patients with chronic odontogenic maxillary sinusitis with the presence of galvanism in the oral cavity (compensated and decompensated forms), chronic inflammation in the maxillary sinus occurred without pronounced clinical symptoms. Exacerbation of the inflammatory process was rare. Among the inflammatory complications in the postoperative period, we found only gingivitis in the oral cavity. We did not observe any other inflammatory complications in the area of the postoperative soft tissues of the postoperative wounds and recurrence of inflammatory disease of the maxillary sinus. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors.","PeriodicalId":166002,"journal":{"name":"Paediatric Surgery. Ukraine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139334768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In vitro evaluation of antimicrobial and anti-biofilm properties of antiseptics against multidrug resistant clinical Escherichia coli strains, isolated from combat wounds","authors":"O. Nazarchuk, T. Denysko, D. Dmytriiev, N. Chornopyshchuk, O. Hruzevskyi, V. Burkot, H. Nazarchuk, K. Ksenchyna","doi":"10.15574/ps.2023.80.8","DOIUrl":"https://doi.org/10.15574/ps.2023.80.8","url":null,"abstract":"The necessity for the investigation of novel approaches and strategies for the treatment of multidrug-resistant E. coli related infections becomes more and more essential. Purpose - to investigate and compare the level of antimicrobial and anti-biofilm activity of antiseptic preparations against MDR clinical isolates of E. coli. Materials and methods. In vitro effectiveness of modern antiseptics; octenidine 0.1% (OCT), polyhexanide 0.1% (PHMB), chlorhexidine 0.5% (CHG), miramistin 0.01% (MRM), decamethoxine 0.1% 0.02% (DCM), povidone-iodine 10% (PVP-I), was determined against forty-six polyresistant clinical strains of E. coli. MIC, MBC were found by standard methods, the value of which was interpreted as a bacteriostatic and bactericidal index of antiseptic activity (BS IAA and BC IAA). The effect of antiseptics on the immature biofilm was modelled using the Christensen test. Results. MIC and MBC values were the lowest in DCM and OCT. The highest values of the antiseptic activity index (IAA>4) were determined for the antiseptics PHMB 0.1%, OCT 0.1% and DCM 0.1%. It was found that the feasibility of using MRM at a concentration of 0.01% is questionable as the BS IAA is above the threshold value, while the BC IAA is not. The effectiveness of PVP-I 1% against MDR E. coli was found insufficient. Sub-bacteriostatic concentrations of DCM, CHG, and PHMB reliably inhibited the formation of E. coli biofilms within 24 hours. MRM and PVP-I in sub-bacteriostatic concentrations stimulated biofilm formation. Conclusions. Based on the analysis of all conducted studies, 0.1% and 0.02% DCM, 0.05% CHG, 0.1% OCT, 0.1% PHMB, 10% and 2% PVP-I are the most active against MDR clinical isolates of E. coli. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.","PeriodicalId":166002,"journal":{"name":"Paediatric Surgery. Ukraine","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139334943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ureteral obstruction after endoscopic treatment of the vesicoureteral reflux in children","authors":"V.F. Peterburgskyy, O.A. Kalishchuk, A. Klius","doi":"10.15574/ps.2023.80.78","DOIUrl":"https://doi.org/10.15574/ps.2023.80.78","url":null,"abstract":"Purpose - to investigate the ureteral obstruction (UO) frequency after endoscopic injection of the vesicoureteral reflux (VUR) in children. Materials and methods. 1068 children aged 8 months -15 years were respectively reviewed after endoscopic treatment of the VUR grades 2-4. The following factors were analyzed in terms of ureteral obstruction: age, sex, reflux grade. Also the clinical manifestations were reviewed as the ureteral obstruction management types (conservative - 28 (52.8%), stenting - (26.5%), reimplantation of the ureter - 11 (20.7%) as well. Statistical analysis of the frequency of OS (categorical data) was performed using nonparametric estimation methods (χ², Fisher's exact test). A difference of p<0.05 was considered statistically significant. Results. The total incidence of ureteral obstruction was 3.44% (53/1539 ureters). There were early (41 children) and late (12 children) obstructed units. The following risk factors for developing ureteral obstruction proved to be significant: sex (males), low reflux grade. The early UO was treated mostly with watchful waiting, stenting (13 cases) and 2 cases were submitted to open surgery. In late UO ureteral reimplantation was utilized (9 cases) as well as ureteral stenting was helpful. Conclusions. UO is an infrequent but essential complication of the endoscopic VUR correction. The early UO cases are effectively treated by watchful waiting with/without empty bladder or ureteral stenting. Ureteral reimplantation seems to be the main procedure in late UO cases. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.","PeriodicalId":166002,"journal":{"name":"Paediatric Surgery. Ukraine","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139334777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Morphological changes of the vaginal process wall of the peritoneum in the case of its obliteration disorders in children of different age groups","authors":"A. V. Havryliuk, V. Konoplitskyi","doi":"10.15574/ps.2023.80.50","DOIUrl":"https://doi.org/10.15574/ps.2023.80.50","url":null,"abstract":"According to statistical data, diseases associated with defects of the vaginal process of the peritoneum (such as inguinal hernia, conjunctive hydrocele of the testicles, cyst of the elements of the spermatic cord) continue to occupy a significant place among the pathologies detected in the children’s population. According to literary sources, such diseases and possible complications that may arise during their treatment can contribute to the development of male infertility, which, in turn, can negatively affect the reproductive health indicators of the nation. Purpose - the study of morphological changes in the wall of the vaginal process of the peritoneum with its non-obliteration to reveal the histological features of its structure depending on the age of children. Materials and methods. The study included children whose age did not exceed 7 years and who had disorders of obliteration of the vaginal process of the peritoneum in the form of inguinal hernias, hydrocele of the testicles and cysts of the elements of the spermatic cord. In the course of an operative treatment, a fragment of the wall of the vaginal process of the peritoneum was removed from such patients for the purpose of further studying its histological structure. Results. In the histological samples, muscle, fibrous and fatty elements were found in different amounts and ratios. The presence of degenerative pathohistological changes contributing to the formation of hernial defects of the inguinal canal was revealed. Also, with age, a progressive development of the processes of atrophy of muscle fibers with their vacant replacement mainly by adipose tissue was observed. Conclusions. Analyzing the conducted morphological studies of the wall of the non-obliterated vaginal process of the peritoneum in children, it should be noted that there is a direct relationship between the number of fatty elements in the tissue of the vaginal process and the age of the patient and also an inverse relationship between the number of muscle elements in the tissue of the vaginal process and the age of the child. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors.","PeriodicalId":166002,"journal":{"name":"Paediatric Surgery. Ukraine","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139334818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Problems of diagnosis and treatment of tourniquet syndrome in gunshot wounds of the upper and lower extremities","authors":"E. Khoroshun, V. V. Makarov, V. Nehoduiko, S. A. Shipilov, Y.V. Klapchuk, S. Tertyshnyi","doi":"10.15574/ps.2023.80.83","DOIUrl":"https://doi.org/10.15574/ps.2023.80.83","url":null,"abstract":"The article presents topical issues of diagnostic monitoring of changes in vascular status when using a tourniquet during a combat injury, diagnosis of tourniquet syndrome. An alternative diagnostic approach in the form of additional use of multifocal express muscle biopsy and dynamic digital thermography has been demonstrated. Purpose - to conduct an analysis of the problematic issues of diagnosis and treatment of tourniquet syndrome in gunshot wounds of the limbs in order to reduce the number of organizational and technical errors in wounds of the limbs where a tourniquet was used. Materials and methods. In the 16 months since the beginning of Russia’s full-scale aggression against Ukraine, 28 wounded people with tourniquet limb syndrome were treated in the Military Medical Clinical Center of the Northern Region (MMCC of the Northern Region). All the wounded were male, the average age was 34.2±0.6 years. The analysis of the following indicators was carried out: the timing of applying a tourniquet before arrival at ROLE 2, the localization of the tourniquet, the amount of surgical intervention at ROLE 2, the length of stay at ROLE 2, the amount of pre-operative examination in the MMCC of the NR, the amount of surgical interventions in the conditions of the MMCC of the NR, the number of cases of acute kidney injury, the need for renal replacement therapy, the average bed-day on ROLE 3, the level of mortality. Classical general clinical studies were carried out in combination with thermographic and histological research. Results. In terms of localization, in gunshot wounds with tourniquet syndrome, wounds of the lower extremities prevail 28 (82.4%) over the upper extremities 6 (17.6%). There were 12 (35.3%) cases of gunshot fractures in tourniquet syndrome. All (28 patients) injured people arrived with tourniquets on their limbs. The terms of applying a tourniquet before hospitalization on ROLE 3 - from 3 hours 10 minutes to 11 hours 25 minutes, on average - 5 hours 35 minutes ±20 minutes. In 5 (14.7%) cases, there were attempts to remove the tourniquet when it was applied for more than 3 hours at the ROLE 1 level. In 6 (21.4%) of the wounded, there were 2 tourniquets on one anatomical and functional site, which led to amputation on proximal level. The average length of stay at ROLE 2 with tourniquet syndrome was 60±10 hours. All wounded (28 patients) with tourniquet syndrome underwent 34 amputations. 16 (57.1%) wounded with tourniquet syndrome had acute kidney injury and were on prolonged renal replacement therapy. This category of wounded had a tourniquet syndrome at the level of the thigh. Polyfocal express muscle biopsy and dynamic digital thermography were used to diagnose tourniquet syndrome. Conclusions. Improving the training of combat medics will lead to a decrease in the number of organizational and technical errors in limb injuries where a tourniquet is used. A tourniquet applied for a long time leads to a high level of limb amputation ","PeriodicalId":166002,"journal":{"name":"Paediatric Surgery. Ukraine","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139335251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastrointestinal bleeding in children: diagnosis, analysis, and structure","authors":"V. Dihtiar, M. Savenko, O. Barsuk, S.O. Shchudro, M.O. Kaminska","doi":"10.15574/ps.2023.80.59","DOIUrl":"https://doi.org/10.15574/ps.2023.80.59","url":null,"abstract":"The incidence of gastrointestinal bleeding is a significant concern among adult patients with gastrointestinal tract (GIT) disorders, as it is a leading cause of mortality. However, there is growing evidence of changes in the pattern of gastrointestinal pathologies among children, primarily attributed to an increasing number of cases related to peptic ulcer disease (PUD) and erosive processes of the GIT. Purpose - to investigate the prevalence and analyze changes in the structure of GIT diseases in children complicated by upper gastrointestinal bleeding (GIB), based on esophagogastroduodenoscopy (EGD) data. Materials and methods. Based on the clinic’s records, a total of 4,457 children underwent EGD at the Regional Medical Center of Family Health in Dnipro. Among them, 1,393 (31.25%) patients were admitted to the surgical department with suspected GIB. In 201 (14.4%) cases, EGD was performed during active bleeding to determine its origin. The utilization of EGD during the acute phase in patients with suspected GIB is considered highly effective for both diagnosing the bleeding source and initiating early-stage treatment. The data were processed using the methods of variation statistics using the Statistica v 6.1 software package. To compare the relative indicators, the Pearson Hi-quadrat test (χ2) and the two-sided Fisher’s exact test (TCF) were used. The critical level of statistical significance (p) was accepted as <0.05. Results. To conduct a comparative analysis of diagnosed cases of GIB, two groups of children with endoscopically confirmed GIB were formed: the Group I (n=125) representing the period of 2012-2013, and the Group II (n=201) - the period of 2020-2021. The results revealed an increase of 1.6 times in the number of patients with upper GIT diseases accompanied by bleeding in the Group II. Additionally, a significant rise in the frequency of GIT diseases, specifically erosive esophagitis, was observed. The number of patients with erosive esophagitis tripled in the Group II compared to the Group I. Conclusions. In recent years, there has been a notable rise in GIT diseases accompanied by upper GIB. The number of such cases increased by 1.6 times, from 125 to 201 patients. Notably, there is a pronounced increase in the incidence of erosive esophagitis, particularly among children in the early and younger age groups. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.","PeriodicalId":166002,"journal":{"name":"Paediatric Surgery. Ukraine","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139335043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The first intravital case of diagnosis and treatment of a giant teratoma of the sacrococcygeal area, which exceeded the body weight of a newborn on 1.5 times","authors":"O. Sliepov, O.V. Perederii, N.Y. Skrypchenko, V.V. Kotsovsky, O.P. Hladyshko, G. Grebinichenko","doi":"10.15574/ps.2023.80.92","DOIUrl":"https://doi.org/10.15574/ps.2023.80.92","url":null,"abstract":"Purpose - is to analyze and present the experience of perinatal diagnosis and treatment of giant terato-dermoid tumor (TDT) of the sacrococcygeal area, which exceeded the body weight of a newborn on 1.5 times. Clinical case. The article presents a unique clinical case of a giant teratoma of the sacrococcygeal area (SCT), which exceeded the weight of a newborn child on 1.5 times. Features of perinatal support, hypoxic-ischemic damage of internal organs, and surgical intervention for giant SCT in a premature low-weight newborn child are described, which are important elements of optimizing the treatment of children with this life-threatening pathology. Conclusions. Diagnosis and treatment of giant SCT in fetuses and newborns require scientifically based perinatal support, which includes early (up to 22 weeks of gestation) prenatal diagnosis, rational pregnancy management tactics, fetal examination, delivery by caesarean section, postnatal diagnosis and early (within 1 days) emergency radical tumor removal. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting studies. No conflict of interests was declared by the authors.","PeriodicalId":166002,"journal":{"name":"Paediatric Surgery. Ukraine","volume":"140 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139334890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}