Paediatric Surgery. Ukraine最新文献

{"title":"Acute necrotizing pneumonia and pyofibrinothorax in an experiment","authors":"A.A. Halahan, V. Dihtiar, D.M. Lukianenko","doi":"10.15574/ps.2023.80.21","DOIUrl":"https://doi.org/10.15574/ps.2023.80.21","url":null,"abstract":"Nowadays, the problem of diagnosis and treatment of purulent-destructive diseases of the bronchopulmonary system in children remains relevant, that is connected with a large number of pulmonary-pleural forms and complications of acute necrotizing pneumonia. Purpose - to establish the correlation of changes in lung tissue and the pleural cavity of a growing organism, depending on the causative agents of pneumonia, elucidation and study of the mechanisms of pyofibrothorax formation and development. Materials and methods. The characteristic features of histopathological tissue changes in the lung parenchyma and adjacent tissues have been analyzed (visceral and parietal pleura, adhesion formation sections) of 45 immature laboratory rats, divided into 5 groups: the control group (intact animals), the Group 2 - contaminated with Klebsiella pneumoniae, the Group 3 - Staphylococcus aureus, the Group 4 - Candida albicans and the Group 5 with mixed flora (Klebsiella pneumoniae+Staphylococcus aureus) adding fungal infection (Candida albicans). Results. It was proved that the formation of a massive pyofibrinothorax is enhanced by mixed flora with the addition of fungi, that is more pronounced in the fifth series (group) of the experiment. Taking into account the data obtained experimentally, we consider whether fungi are Lukianenkoobtained in cultures of patients’ flora, they should be classified as a risk group of fibrothorax formation. Conclusions. Morphological changes of tissues under the influence of the infectious agent reached their maximum on the ninth day of the experiment (p<0.05). The pattern of necrotizing pneumonia is more pronounced in the Group 5 of experimental animals, which morphologically manifests itself in a more massive inflammatory infiltration (mostly due to rod- and segmented-nuclear neutrophils), foci of destruction and abscessation of the lung parenchyma and has a direct association with the polymicrobial etiology of the disease (Klebsiella pneumoniae+Staphylococcus /taureus+Candida albicans) (p<0.05). The formation of a massive pyofibrinothorax is enhanced by mixed flora, especially with the addition of fungi. The study was carried out in accordance with the principles of the European Convention for the Protection of Vertebrate Animals used for Experimental and Other Scientific Purposes, as well as the law of Ukraine. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the article. No conflict of interests was declared by the authors.","PeriodicalId":166002,"journal":{"name":"Paediatric Surgery. Ukraine","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139334942","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":"Study of stress distribution under the influence of bending load in models of different options for osteosynthesis of tibia bones with fractures in the middle third of their congenital pseudarthrosis in children with incomplete growth","authors":"M. Korzh, S.O. Khmyzov, E. Katsalap, M. Karpinsky, O.D. Karpinska, O. Yaresko","doi":"10.15574/ps.2023.80.71","DOIUrl":"https://doi.org/10.15574/ps.2023.80.71","url":null,"abstract":"Congenital pseudoarthrosis of the bones of the lower leg is a rare disease characterized by the presence of non-union (pseudoarthrosis) of the bones of the lower leg, which does not grow independently. The majority of surgical techniques involve the removal of pathological soft tissues in the zone of pseudarthrosis followed by bone autoplasty and fixation of tibial bone fragments in external fixation devices or with the help of intramedullary fixators. Purpose - to investigate the stress-deformed state of models of the leg in the presence of pseudarthrosis in the middle third under the influence of bending load and their osteosynthesis using intramedullary rods of various designs in children with incomplete growth. Materials and methods. Mathematical modeling of 3 variants of osteosynthesis of lower leg bones with congenital pseudarthrosis in the middle third was performed: 1 - rod without rotational stability; 2 - rod with rotational stability; 3 - rod with rotational stability and blocked movement during compression. The stress-strain state of the models under the influence of a bending load of 300 N was studied. Results. When using a rotationally unstable «growing» rod, maximum stress levels of 18.5 MPa and 23.1 MPa are determined at the proximal and distal ends of the tibia, respectively. In the fracture zone, the stress level is minimal and does not exceed 0.2 MPa. In the diaphyseal part, stresses are determined at the level of 0.3 MPa and 0.4 MPa above and below the fracture zone, respectively. In the zone of the fracture of the fibula, the stress level is also not significant - 0.7 MPa and 0.8 MPa in the proximal and distal fragments. The use of a rod with rotational stability does not lead to any significant changes in the stress-strain state of the model compared to tibial osteosynthesis with a rotationally unstable rod. The use of an intramedullary rod with blocked movement during compression allows to reduce the values of stresses at the proximal and distal ends of the tibia - up to 16.9 MPa and 21.2 MPa, respectively. In all control points of the diaphyseal part of the tibia, the stresses are minimal and equal to 0.2 MPa. It should be noted that in this case the stresses in the area of the fracture of the fibula, where they do not exceed the mark of 0.1 MPa, are almost negligible. Conclusions. Under bending loads, all types of intramedullary rods provide a minimum level of stress in the tibial fracture zone. Additional rotational and longitudinal stability of the rods allow to slightly reduce the level of stress in the proximal and distal ends of the tibia. 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":"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":"139335084","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":"Efficacy of regional analgesia in prevention of chronic postsurgical pain in children on the PEDSQL General Well-Being Scale and Pediatric Pain Questionnaire","authors":"Y. Semkovych","doi":"10.15574/ps.2023.79.7","DOIUrl":"https://doi.org/10.15574/ps.2023.79.7","url":null,"abstract":"Introduction. In pediatrics, regional anesthesia is one of the most valuable and safest means of perioperative pain management and chronic pain prevention. Pediatric Quality of Life Inventory 3.0 General Well-Being Scale and Pediatric Pain Questionnaire allow for assessing the impact of pain on children and their families via studying changes in Quality of Life scores for the scales of Present Pain and Worst Pain, General Well-Being and General Health. Purpose - to assess the impact of regional analgesia on the prevention of chronic postsurgical pain using PedsQL™ 3.0 questionnaires. Materials and methods. Following the inclusion and exclusion criteria, a total of 80 children were enrolled in the study. Among them, there were 60 children who underwent anterior abdominal wall surgery with various types of anesthetic management and were treated at the surgical department of a Communal Non-Profit Enterprise “Ivano-Frankivsk Regional Children’s Clinical Hospital of Ivano-Frankivsk Regional Council”. All patients were divided into 4 groups. The Group 0, the control group, included 20 children who had no surgical pathology and met inclusion criteria. The Group I comprised 20 children who underwent anterior abdominal wall surgery under general anesthesia using the transversalis fascia plane block combined with the quadratus lumborum block-4 via a single injection. The Group II included 20 children who underwent anterior abdominal wall surgery under general anesthesia using morphine. The Group III comprised 20 children who underwent anterior abdominal wall surgery under general anesthesia using the transversalis fascia plane block. Results. The prevalence of chronic pain syndrome in children who received conventional analgesia was the highest - 19.81±0.21%. Children who underwent conventional analgesia, while staying in the surgical department, had significantly higher the Face, Legs, Activity, Cry, Consolability scale and Visual Analogue Scale scores as compared to those who received other forms of regional analgesia. Discussion. Three and six months after surgery, in patients who received conventional analgesia, quality of life significantly reduced (p<0.001) on the scales of General Well-Being, General Health, Present Pain, and Worst Pain. This shows the need for using effective minimally invasive regional analgesia techniques in the perioperative period. Conclusions. Chronic pain syndrome reduces quality of life in children by reducing their general well-being and general health due to high indicators of present and worst pain. Regional analgesia techniques are a priority for the prevention of chronic pain syndrome. 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":"263 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124212574","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":"Video laparoscopy for closed abdominal trauma with liver and spleen damage","authors":"P. Gerasymchuk, D. Osadchuk, D. Fira, A. V. Pavlyshyn","doi":"10.15574/ps.2023.79.44","DOIUrl":"https://doi.org/10.15574/ps.2023.79.44","url":null,"abstract":"Open and closed abdominal trauma is the structure of traumatic injuries makes up from 1.5% to 36.5% of all injuries, accompanied in 26.7-40.8% of cases by liver and spleen damage. Damage to parenchymal organs of the abdominal cavity most often leads to the development of intra-abdominal bleeding, which is the basis of unsatisfactory results of treatment and death of patients. Among the diagnostic methods, video laparoscopy is becoming more and more important in finding the extent of damage to the internal organs of the abdominal cavity. In emergency cases as a minimally invasive but sufficiently informative research method, which in 20-60% of cases allows to supplement, clarify or change the diagnosis. The sensitivity of diagnostic laparoscopy in the case of damage to the organs of the abdominal cavity is 99-100%. Purpose - to study the role and place of video laparoscopy in the diagnosis and treatment of closed abdominal trauma with damage to the liver and spleen. Materials and methods. The results of using video laparoscopy in the diagnosis and treatment of closed abdominal trauma with isolated liver and spleen damage in 131 patients were retrospectively analyzed. The diagnostic search program included clinical, laboratory-biochemical, radiographic studies, ultrasound examination of the abdominal organs according to the FAST protocol, computed tomography, laparocentesis using a search catheter, diagnostic peritoneal lavage, laparoscopy, which were performed in a comprehensive examination according to indications. The obtained data are presented in the form of absolute (number of cases) and relative (%) values. The validity of laparoscopy was considered statistically significant at p˂0.05. Results. Video laparoscopy of the abdominal cavity in the case of a closed injury with isolated damage to parenchymal organs allows to diagnose the nature of the damage in the shortest possible time and to determine the treatment tactics. This method in the diagnosis of hemoperitoneum and injuries of the liver and spleen is informative (100%), sensitivity - 92.8%, specificity - 94.6%, at p<0.05. All laparoscopic operations for injuries of the liver and spleen were ended with a thorough revision, sanitation and drainage of the abdominal cavity. We did not observe complications related to endo-video surgery in this group of patients. There were no fatal consequences. This indicates that the use of minimally invasive laparoscopic methods of treatment in this group of patients helps to reduce the severity of surgical trauma and the frequency of various postoperative complications. Conclusions. Laparoscopy is a highly informative method of diagnosing intra-abdominal damage to the liver and spleen in case of closed abdominal trauma with the possibility of carrying out medical measures. It allows you to prevent and significantly reduce the frequency of postoperative complications, improve the results of treatment, and shorten the hospitalization period of the patient","PeriodicalId":166002,"journal":{"name":"Paediatric Surgery. Ukraine","volume":"229 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133670345","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":"Simultaneous treatment for anal fissure and hemorrhoids","authors":"J.P. Feleshtynsky, A. J. Noyes","doi":"10.15574/ps.2023.79.66","DOIUrl":"https://doi.org/10.15574/ps.2023.79.66","url":null,"abstract":"When using surgical approach to treatment for combined anal fissure and hemorrhoids doctor always faces the question of whether to divide the procedure into two sequential stages or to perform a simultaneous surgical intervention, and in which cases one or the other should be done. Purpose - to improve the results of treatment for patients with anal fissure in combination with chronic hemorrhoids by combining fissurectomy with transanal hemorrhoidal dearterialization (THD). Materials and methods. 177 patients with combination of anal fissure and hemorrhoids were studied. The Group I (GI) - fissure excision and hemorrhoidectomy, 60 patients. The Group II (GII) - anal fissure excision without surgery for hemorrhoids, 60 patients. The Group III (GIII) - proposed method used, 57 patients. Laser Doppler flowmetry was performed to assess blood flow intensity in fissure area. The assessment of treatment outcomes in patients was based on the following criteria: pain intensity, urinary retention in early postoperative period, postoperative wound suppuration, disease recurrence, iatrogenic incontinence, duration of postoperative hospital stay. Qualitative parameters are presented as the absolute number of cases (n) and their percentage (%). Comparison of these parameters between groups was performed using the Pearson’s χ2 test and the Fisher’s exact test. Statistical analysis was conducted by STATA 12.1 statistical package. Results. Pain intensity: GI - 8±1, GII - 6±2, GIII - 4±1. Urinary retention: GI - 19 (31.6%), GII - 8 (13%), GIII - 6 (10.5%). Wound suppuration: GI - 5 (8.3%), GII - 1 (1.7%), GIII - 1 (1.7%). Hospital stay (days): GI - 6±1.2, GII - 4±1.3, GIII - 3±1.1. Fissure recurrences: GI - 5 (8.3%), GII - 2 (3.3%), GIII - 1 (1.7%). Hemorrhoid recurrence: GI - 6 (10%), GIII - 2 (3.5%). Iatrogenic incontinence: GI - 4 (6.7%), GII - 1 (1.7%), GIII - 0. Significant decrease in relative risk of complications (by 88%) in GIII compared with GI - OR=0.12 (0.04-0.29), p=0.0001, and a tendency to reduction of complication risk by 15% compared with GII - OR=0.85 (0.29-2.4), p=0.734 was observed. Blood flow intensity (flowmetry results) in GII and GIII was comparable. Conclusions. Simultaneous anal fissure excision and THD can improve treatment outcomes. This method does not impair blood flow in the area of anal fissure. Proposed method is both radical and minimally invasive. 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":"106 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128608246","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":"Small intestinal obstruction by food in young children: a view on the problem, literature data and own clinical observations","authors":"V. Rybalchenko, P. Rusak, B.S. Rinzberg, N.M. Nagornyuk, S. Sagan","doi":"10.15574/ps.2023.79.92","DOIUrl":"https://doi.org/10.15574/ps.2023.79.92","url":null,"abstract":"Purpose - to improve the results of treatment of young children with small intestinal obstruction due to the introduction of informative imaging technologies and modern video treatment technologies; to present own clinical observations of food-related obstruction of the digestive tract in young children and their treatment. The article provides a review of the literature on small intestinal obstruction caused by food in young children. Only four cases have been established. There are 2 cases of food obstruction (corn kernels, pineapple, red fish) in children under 3 years of age. Based on my own experience, the use of the term «phytobezoar» in the treatment of small intestinal obstruction is substantiated. All underwent surgical treatment: 1 - laparotomy, 1 - laparoscopic. All children recovered and were discharged from the clinic. The diagnosis and verification of food-related intestinal obstruction in young children is primarily based on the results of a thorough history. It is advisable to use the following methods in order to verify the location of the obstruction and establish the factor: X-ray examination of the organs of the abdominal cavity, both during hospitalization and during the course of the disease, CT scan, as well as ultrasound of the abdominal cavity. The presence of doubts in determining the cause of small intestinal obstruction is an indication for diagnostic laparoscopy. The interpretation of the term phytobezoar should have a basis, taking into account the time of obstruction and stay of the product in the digestive system, conditions and types of food. The study was conducted in accordance with the principles of the Declaration of Helsinki. Informed consent from the child’s parents was obtained for the research. No conflict of interests was declared by the authors.","PeriodicalId":166002,"journal":{"name":"Paediatric Surgery. Ukraine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130142352","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":"Experience in extended pancreatoduodenal resections performing in patients with malignant neoplasms of the pancreatobiliary zone complicated by obstructive jaundice syndrome","authors":"P.T. Muravіov, B. Zaporozhchenko, І.Ye. Borodaiev, V. Kolodiy, V. Shevchenko, K. Kirpichnikova","doi":"10.15574/ps.2023.79.35","DOIUrl":"https://doi.org/10.15574/ps.2023.79.35","url":null,"abstract":"Despite the results of randomized trials, mortality and survival rates, clinical aspects of extended pancreaticoduodenal resection remain a subject of debate. Purpose - to determine the effect of the pancreaticoduodenal resection volume expanding on the results of surgical intervention. Materials and methods. The results of surgical treatment of 101 patients with malignant neoplasms of the pancreatobiliary zone, complicated by mechanical jaundice syndrome, were analyzed. Depending on the volume of lymph node dissection, patients were randomized into two cohorts. The main group included 33 (32.7%) patients who underwent an extended version of pancreatoduodenal resection; the comparison group included 68 (67.3%) patients who underwent standard pancreaticoduodenal resection. Results. Intraoperative blood loss in extended interventions somewhat exaggerated the volume of blood loss in standard ones, however, there was no statistically significant advantage (522±165) ml versus (468±124) ml (p>0.05). In patients after extended surgical interventions, the average debit of lymph through the drains was (512±26) ml/day, which was almost 46.2% higher than the average amount of lymph outflow through the drains in patients after standard ((236 ± 31) ml/day) and was statistically confirmed (p<0.05). Secretory diarrhea lasting more than 2 weeks, as a complication of extended pancreatoduodenal resection, occurred in 7 (21.2%) patients, and after the standard one - only in 3 (4.4%) (p<0.05). A life-threatening postoperative complication as failure of the pancreatodigestive anastomosis due to pancreatic necrosis of the pancreatic stump complicated the course of the postoperative period in 9 (13.2%) patients after standard interventions, while after extended interventions it was diagnosed in 4 (12.1%) patients. Mortality after standard pancreatoduodenal resection was 7.4% (5 patients), after extended resections - 6.1% (2 patients). Conclusions. On the one hand, the obtained results demonstrate more difficult conditions of extended pancreaticoduodenal resection performing, and, on the other hand, the absence of statistically significant differences with standard intervention in terms of the frequency of complications. 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":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116883249","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 isolated and associated congenital rectoperinetic fistura in children","authors":"O.Р. Dzham, O. Sliepov","doi":"10.15574/ps.2023.79.58","DOIUrl":"https://doi.org/10.15574/ps.2023.79.58","url":null,"abstract":"Congenital anorectal malformations (CARM) include a number of different options that differ in their anatomical and functional features. One of these options is rectoperineal fistula (RPF). Purpose - to evaluate the results of surgical treatment of congenital RPF in children, using a differentiated approach to diagnosis and methods of correction of its isolated and associated forms. Materials and methods. The study included 28 patients with RPF, which accounted for 18.2% of all treated CARM: boys - 18 (64.3%), girls - 10 (35.7%). Verification of the main disease and associated developmental defects was carried out on the basis of clinical and instrumental research methods. Isolated anorectal malformation (ARM) was diagnosed in 15 (53.6%) children, 8 (53.3%) boys, 7 (46.7%) girls, and associated - in 13 (46.4%) patients, 10 (76.9%) boys, 3 (23.1%) girls. Results. One-stage surgical treatment was performed in 2 (7.1%) patients with associated ARM. Staged surgical treatment, with colostomy removal and anorectoplasty, was performed in 26 (92.9%) children. Anterosagittal anorectoplasty was performed in 14/26 (53.8%) of children: 10 (71.4%) boys, 4 (28.6%) girls; minimal posterior sagittal - in 26.9% (7/26): 2 (28.6%) boys, 5 (71.4%) girls; posterior sagittal according to Pen, applied in 19, 2% (5/26), and only in boys. The third stage of treatment included closing the stoma from local access. Removal of the colostomy and formation of an end-to-end anastomosis was performed in 25 (96.1%) patients without complications. Conclusions. The use of a differentiated approach to diagnostics and methods of anorectoplasty, as well as the use of a complex of rehabilitation treatment for isolated and associated forms of ARM, allowed to obtain good results - in 81.5% and satisfactory results - in 18.5% of children. The choice of tactics for surgical correction of RPF should be individual for each patient, considering the anatomical and functional features of the defect, gender and the presence of a certain range of associated malformations. 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":"81 4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114403911","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":"Congenital midline cervical cleft (literature survey and description of own clinical observations)","authors":"O. Lukiianets, A. Sasiuk, V. Konoplitskyi, Ya.Yu. Marunkevych, K. Pedorenko","doi":"10.15574/ps.2023.79.85","DOIUrl":"https://doi.org/10.15574/ps.2023.79.85","url":null,"abstract":"Midline cervical cleft - (synonym: webbed neck, pterygium colli medianum, neck ugliness), belongs to rare congenital defects which, unfortunately, have not been widely covered in the specialized medical literature at the modern stage of the development of medicine. It is confirmed by the fact that until 2014 according to the literature search there were a little over 100 detailed descriptions of the respective pathology. Purpose - to summarize the experience accumulated by experts in order to understand deeper all the aspects of Congenital midline cervical cleft, to introduce the present position of this rare congenital malformation to colleagues, to learn the structural parts of this pathology and the tactic for its treatment. The article represents the last data from scientific literature about Congenital midline cervical cleft and the analytic results of the two medical cases with this congenital malformation in children. Studying these cases, we used general clinical tests and histological research for the removal tissues. Conclusions. The current lack of information on the midline cervical cleft as well as the results of histological examinations in different clinical cases confirm the necessity of further study of this rare congenital defect. In this case, a deeper analysis of embryological, genetic and environmental factors influencing the process of formation of this pathology can be of help. In our opinion, performing the surgery becomes appropriate before two-year age in order to prevent the relapse of this pathology and severe neck contractures in the future. The study was carried out in accordance with the principles of the Helsinki declaration. 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":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115094481","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":"Analysis of the effectiveness of methods of correction of pronation deformities of the feet in children with cerebral palsy","authors":"O. Danilov, V. Gorelik, O. Shulga","doi":"10.15574/ps.2023.79.50","DOIUrl":"https://doi.org/10.15574/ps.2023.79.50","url":null,"abstract":"Pronation deformities of the feet are one of the most common childhood deformities requiring surgical treatment. For correction subtalar arthroereisis and subtalar arthrodesis according to Grice are used. The use of these methods in combination with the transposition of the gastrocnemius muscle is promising. Purpose - тo study the effectiveness of subtalar arthroereisis and subtalar arthrodesis according to Grice in combination with transposition of the gastrocnemius muscle in the correction of pronation deformity of the feet in children with cerebral palsy. Materials and methods. The results of treatment of 40 patients aged 7 to 16 years with pronation deformity of the feet were analyzed. Patients were divided into 2 groups. The main group (25 patients) was divided into 2 subgroups depending on the method of surgical treatment: the subgroup A - 10 patients who underwent subtalar arthroereisis with transposition of the tendon of the short peroneal muscle; the subgroup B - 15 patients who underwent subtalar arthrodesis according to Grice with transposition of the tendon of the short peroneal muscle. The control group included 15 patients who underwent subtalar arthrodesis according to Grice. Clinical and radiological methods were used to examine patients. Numerical data were compared between groups and processed statistically with the determination of M±m and the coefficient of reliability by Student’s t-test. The level of probability was set at p<0.05. Results. The advantage of subtalar arthroereisis and subtalar arthrodesis according to Grice in combination with transposition of the gastrocnemius muscle is the elimination of its pronation pathological effect on the foot, increased supination effect of the posterior tibialis muscle, as well as reduced compression on the autoimplant when performing subtalar arthrodesis according to Grice. Conclusions. The effectiveness of peroneal tendon transposition in combination with subtalar arthroereisis or arthrodesis in the correction of pronation deformity of the feet in children with cerebral palsy has been proven, which allows improving clinical and radiological parameters after treatment. The study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the local ethics committees of all institutions participating in the study. Informed consent was obtained from the patients. No conflict of interests was declared by the authors.","PeriodicalId":166002,"journal":{"name":"Paediatric Surgery. Ukraine","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124309164","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}