Paediatric Surgery. Ukraine最新文献

{"title":"Stone formation in the augmented urinary bladder in childhood: the current state of the problem","authors":"D. Shevchuk, R. Nakonechnyy","doi":"10.15574/ps.2023.79.78","DOIUrl":"https://doi.org/10.15574/ps.2023.79.78","url":null,"abstract":"Purpose - to analyze the current state of the problem patients’ treatment with stones in the augmented bladder and recommend optimal approaches for their elimination, based on the literature data. Augmentation cystoplasty is a surgical procedure used in adults and children with refractory bladder dysfunction, including, in particular, small bladder capacity, in whom conservative treatment has failed. The leading pediatric pathologies for which enterocystoplasty performed are neuropathic bladder and bladder exstrophy. The article examines the complications that arise, and the possibilities and advantages of endoscopic techniques in children compared to open surgery in view of compromised tissues due to congenital defects and previous surgical interventions. The cause of the main postoperative complications, such as metabolic disorders, hematuria syndrome, calculi formation, mucus formation, enteric fistulae, bladder rupture, intestinal obstruction and the development of malignant neoplasms, are mainly related to the use of gastrointestinal tract tissues in the bladder. As an example of modern surgical and minimally invasive methods application, considered the case of treatment of a child with urinary bladder exstrophy, in which later stones were formed. Conclusions. The stones formation in an augmented bladder is a fairly common problem, difficult to prevent and effectively treat. Timely complete bladder emptying and adequate treatment of bladder infections are the keys to preventing the formation of stones in an augmented bladder. Modern minimally invasive technologies make it possible to effectively, minimally traumatical and safely treat patients with calculi of various localizations of the urinary system, as well as patients who have previously undergone complex plastic surgery. The research 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 interest 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":"125394470","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 results of surgical treatment in idiopathic thoracic scoliosis with Cobb angle 80º-100º","authors":"A. Mezentsev, D. Petrenko, D. Demchenko","doi":"10.15574/ps.2023.79.28","DOIUrl":"https://doi.org/10.15574/ps.2023.79.28","url":null,"abstract":"Anterior spinal mobilization is an effective method of staged correction of thoracic idiopathic scoliosis with a Cobb angle of 80-100º. The introduction of modern transpedicular implants and osteotomies of the posterior support complex into clinical practice has reduced the frequency of its use, but increased the number of neurological complications. Purpose - to compare the results of anterior mobilization in combination with posterior corrective fusion and posterior corrective fusion alone in patients with stiff thoracic idiopathic scoliosis. Materials and methods. A retrospective comparative analysis of the results of surgical treatment of 167 patients with thoracic idiopathic scoliosis with a Cobb angle of 80-100º was performed. Patients were divided into two groups: the Group 1 - 83 patients (mean age - 13.7 years) who underwent anterior curvature mobilization and posterior corrective fusion, the Group 2 - 84 patients (mean age - 14.7 years) who underwent posterior corrective fusion and Ponte osteotomy at 3-5 levels. Results. The average thoracic Cobb angle before surgery in the Group 1 was 87.1º (±1.96), in the Group 2 - 83.8º (±2.85); after surgery - 32.2º (±2.24), or 63% correction, and 44.2º (±3.22), or 47% correction, respectively. The total average duration of surgical interventions in the Group 1 was 410 minutes (140 minutes + 270 minutes), in the Group 2 - 320 minutes. Intraoperative blood loss was 890 ml and 900 ml, respectively. The average volume of haemotransfusion was 650 ml and 672 ml, respectively. The average hospital stay was 15.6 days and 8.6 days, respectively. Conclusions. Compared with posterior corrective fusion, the use of two-stage treatment, which includes anterior mobilization of the curvature and posterior corrective fusion for surgical correction of stiff scoliotic spinal deformities, allows to increase the intraoperative correction of the main curvature by 17%. The study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee of all the institutions mentioned 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":"3 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":"127370897","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":"Advantages of tangential excision with simultaneous autodermoplasty for treating burn wounds","authors":"T. I. Farmaha, O. Lukavetskyi, O. Chemerys","doi":"10.15574/ps.2023.79.23","DOIUrl":"https://doi.org/10.15574/ps.2023.79.23","url":null,"abstract":"Burn trauma remains an important health problem, among which thermal burns of the limbs are one of the most common and complex due to the need to restore limb function and reduce aesthetic defects. Early tangential excision with simultaneous autodermoplasty is a complex technique that is also a significant stress for the patient, but it allows achieving all the set goals. Purpose - to evaluate the effectiveness of tangential excision with simultaneous autodermoplasty for treating burn wounds compared to the classical method of treatment. Materials and methods. The study included 24 patients with burns of the upper and/or lower limbs, from which two groups were formed: an experimental group (12 patients) and a control group (12 patients) who were equal in terms of patient sex, age, etiology of burn wounds, affected area. Tangential excision with simultaneous autodermoplasty was applied to patients in the experimental group, while delayed sequential necrectomy, xenoplasty (if necessary), and delayed autodermoplasty were performed on patients in the control group. Results. Patients in the experimental group stayed in the hospital for an average of 10.5±4.5 days, which was almost half as long as in the control group (20.2±3.5 days). The number of surgical interventions in the experimental group was 1.3±0.5 operations, while in the control group it was 2.7±0.8 operations, and the number of general anesthesia procedures in the experimental group was significantly lower (1.3±0.5) than in the control group (4.6±1.1; p<0.05). In the experimental group, the number of dressings for each injury was 4.3±1.6, while in the control group it was almost three times as many (12.7±3.0; p<0.05). The duration of healing of burn wounds in the experimental group was 13.3±4.3 days, which was shorter than in the control group (24.2±3.9 days; p<0.05). The prevalence rate of infectious complications in the experimental group was 21.1% (4 cases), while in the control group it was significantly higher (58.8%). However, the prevalence rate of other complications, such as lysis of skin grafts, was only slightly lower in the experimental group (15.8%, or 3 cases) compared to the control group (29.4%, or 5 cases). 2 (18.2%) burn wounds in the experimental group required secondary reconstruction, while in the control group, 7 (70.0%) wounds required it. Conclusions. Treatment of burn wounds of the upper and/or lower limbs using the method of tangential excision with simultaneous autodermoplasty allows for a reduction in the length of hospital stay, a decrease in the number of surgical interventions, general anesthesia procedures, dressing changes, and ensures faster wound healing, as well as reduces the frequency of complications and the need for secondary reconstruction. 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","PeriodicalId":166002,"journal":{"name":"Paediatric Surgery. Ukraine","volume":"152 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":"115903400","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":"Comparison of clinical results of Transanal Endorectal Pull-Through of the colon with and without laparoscopic assistance in children with Hirschsprung’s disease","authors":"V. Prytula, O. Kurtash, S. Hussaini, P. Rusak","doi":"10.15574/ps.2023.79.71","DOIUrl":"https://doi.org/10.15574/ps.2023.79.71","url":null,"abstract":"Introduction. Techniques of Transanal Endorectal Pull-Through (TEPT) with and without laparoscopic assistance have been widely used in pediatric surgery for correction of Hirschsprung’s disease (HD) in children with. Many clinics in their studies have noted the positive features of this approach compared to classical methods, but the long-term results after such operations in children are still debated. Purpose - to study and compare the clinical results of TEPT with and without laparoscopic assistance in children with HD. Materials and methods. We analyzed the experience of TEPT approach with laparoscopy (n=65 (29.41%)) and without laparoscopic assistance (n=144 (70.59%)) in childreb for correction of HD. For confirmation diagnosis we used the results of general clinical and special procedures (barium enema, anomanometry, histological, determination of acetylcholesterase activity). Results. Overall, among 55 (26.32%) of 209 patients who underwent TEPT, postoperative in long term follow up we found intestinal problems like - moderate stenosis of the colo-anal anastomosis without incontinence 4 (1.91%), constipation 9 (4.31%), partial faecal incontinence 20 (9.57%) and enterocolitis (EC) 22 (10.53%). There was no significant difference in the clinical results of TEPT with laparoscopy and without laparoscopic assistance in our patients. After TEPT without laparoscopic assistance, 6 (4.17%) of 144 patients had constipation, 11 (7.64%) had partial fecal incontinence, and 16 (11.11%) had enterocolitis (EC). And among 65 children after TEPT with laparoscopy, 3 (4.62%) patients were diagnosed with constipation, 9 (13.85%) with partial fecal incontinence and 6 (9.23%) with EC. All children with postoperative intestinal problems were treated conservatively. There was no need for redo surgical interventions in these patients. Conclusions. The technique of TEPT with laparoscopy and without laparoscopic assistance is a modern method of surgical correction of HD, which has significant technical advantages compared to other existing methods. In 26.32% of children with HD who were operated by the TEPT method, persistent intestinal problems continue in the long term follow-up period. The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of all institutions mentioned in the work. Informed consent of the children’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":"115764486","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":"Methods of treating jaw cysts in children. Retrospective analysis","authors":"V.V. Ododyuk, R.I. Yegorov","doi":"10.15574/ps.2023.79.19","DOIUrl":"https://doi.org/10.15574/ps.2023.79.19","url":null,"abstract":"Odontogenic cysts of the jaws are one of the most common tumour-like neoplasms of the maxillofacial region in children. Today, there are various methods of treating cysts, but in childhood, the problem of choosing a treatment method is relevant and at the same time difficult, as some authors prefer cystectomy, while others prefer cystotomy. Purpose - to analyze the methods of treatment and management of jaw cysts in children depending on the type of cyst. Materials and methods. A retrospective analysis of 286 case histories of patients with jaw cysts aged 4 to 17 years was performed. The case histories were analysed according to the developed examination chart. Results. A retrospective analysis of 286 case histories of children with jaw cysts was performed. The age of the children ranged from 4 to 18 years. Radicular dentoalveolar cysts were diagnosed in 35% (n=100) of cases, radicular cysts - in 36% (n=104), follicular cysts - in 15% (n=43), suppurative cysts - in 5% (n=14), residual cysts - in 5% (n=14), primary bone cysts - in 3% (n=7), polycystic cysts - in 2% (n=4). Cystotomy was performed in the vast majority of cases - 58% (n=166), cystectomy - in 42% (n=120). Tamponade was performed in 63% (n=181) of cases, and in 37% (n=105) it was not performed. Conclusions. Radicular cysts are the most common odontogenic cysts of the jaws. Cystotomy and cystectomy are variable methods of cyst treatment. The most common method of treating cysts in children is cystotomy. 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":"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":"130281090","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":"Tacrolimus-associated sinus obstruction syndrome after liver transplantation from a living related donor","authors":"O. Kotenko, A. O. Matvienkiv, M. S. Hryhorian, A. Minich, I. O. Kotenko, O. S. Mykhailiuk","doi":"10.15574/ps.2023.79.99","DOIUrl":"https://doi.org/10.15574/ps.2023.79.99","url":null,"abstract":"Sinusoidal obstruction syndrome (SOS), previously known as hepatic veno-occlusive disease, is manifested by obliterating inflammation of the terminal hepatic veins, characterized by hepatomegaly, right upper quadrant pain, jaundice and ascites, and most often occurs in patients after hematopoietic stem cell transplantation and usually in those who received platinum drugs. Cases of SOS development in patients after transplantation of solid organs (lungs, pancreas, liver) are also recorded in the world literature. Cases of the development of SOS after transplantation of solid organs are rare, and after transplantation of the liver lobe from a living family donor - isolated and poorly studied. The diagnosis is established on the basis of clinical signs, imaging techniques (according to ultrasound and radiological research methods), histological study of a liver biopsy. Tacrolimus has been reported to be a causative agent that potentially plays a role in the pathophysiological mechanism of SOS. Purpose - to study the relationship between prolonged-release tacrolimus and the development of sinusoidal obstruction syndrome in patients after living donor liver transplantation. Clinical case. In this article, we present a case of SOS after living donor liver transplantation, which was associated with the toxic effect of prolonged-release tacrolimus («Envarsus»). In a 55-year-old man, after living donor liver transplantation, high concentrations of tacrolimus in the blood associated with uncontrolled drug intake were recorded. When carrying out a number of laboratory and instrumental research methods in connection with the appearance of massive ascites, the diagnosis of SOS was established. After excluding other possible contributing factors, including an acute rejection crisis, it was concluded that long-acting tacrolimus («Envarsus») was the cause of SOS. The research 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":"25 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":"126794106","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":"Nakayama esophagoduodenostomy as a reconstructive stage after gastrectomy for gastric cancer complicated by acute bleeding and Krukenberg metastases. Clinical case","authors":"P. Ivanchov, S. Hychka, O.B. Prudnikova, Y. Peresh","doi":"10.15574/ps.2023.79.105","DOIUrl":"https://doi.org/10.15574/ps.2023.79.105","url":null,"abstract":"Purpose - on a clinical case to justify the technical aspects of applying the Nakayama esophago-duodenostomy as a reconstructive stage after gastrectomy for gastric cancer complicated by acute bleeding and Krukenberg metastases. Clinical case. Patient O., born in 1975, was being treated for stomach cancer complicated by moderate acute bleeding and Krukenberg metastases in the surgery department No. 3 of the Kyiv City Emergency Clinical Hospital. The patient general clinical, special laboratory and instrumental research methods were carried out (electrocardiography, esophagogastroduodenoscopy, ultrasound examination of the organs of the abdominal cavity and small pelvis, computer tomography of the organs of the abdominal cavity and small pelvis with intravenous contrast). The patient had cancer of the cardiac part of the stomach, complicated by moderate gastrointestinal bleeding with the presence of Krukenberg metastases, in connection with which the patient underwent surgery in the early delayed period according to a unique method - gastrectomy with lymphodissection in the volume of D2+ and overlapping esophageal-duodenal anastomosis according to the Nakayama type in the modification of the clinic. The patient was discharged in a satisfactory condition on the 10th day after surgery under the supervision of an oncologist and a surgeon at her place of residence. During the dynamic observation for 12 months, she felt satisfactory. Conclusions. Using the example of a clinical case, the technical aspects of applying the Nakayama esophagoduodenostomy as a reconstructive stage after gastrectomy for gastric cancer complicated by acute bleeding and Krukenberg metastases are substantiated. The research 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":"142 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":"133262727","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":"Otoplasty with underdevelopment of the antihelix in children","authors":"V.G. Fomin, І.V. Ksonz, Ie. M. Grytsenko, Y. Pylypiuk","doi":"10.15574/ps.2023.78.30","DOIUrl":"https://doi.org/10.15574/ps.2023.78.30","url":null,"abstract":"Purpose - to develop a method of otoplasty in children with underdevelopment of the antihelix. Materials and methods. Otoplasty in our own way in case of underdevelopment of the antihelix was performed in 47 children (30 girls and 17 boys) aged from 6 to 16 years. All patients had bilateral deformity. The postoperative follow-up period was to 5 years. Results. Otoplasty in children with underdevelopment of the antihelix was performed by our own method, which included detachment of the skin on the posterior and anterior surface of the auricle from the cartilage with an anesthetic solution, excision of the skin in the form of an ellipse on the posterior surface of the auricle, cutting the cartilage to the perichondrium along the outer edge of the antihelix, and making staggered notches on the entire thickness of the cartilage, forming the antihelix with U-shaped sutures. The result of the correction was the correction of proportional disorders, ensuring the symmetry of both ears. First of all, the excessive protrusion of the upper part of the auricle was eliminated, since some protrusion of the middle and lower parts may be acceptable. The full-face helix of both auricles was visualized through an antihelix. An even and smooth contour of the antihelix along its entire length was provided. The nuchal recess was not reduced too much, while its shape was not violated. Excessive pressing of the auricle against the head was avoided. Staggered notches help to reduce the excessive pressure on the suture, prevent tension of the ear cartilage and overcorrection during the formation of the antihelix. Conclusions. The proposed method provides minimal trauma, promotes the formation of a natural antihelix shape and provides a good cosmetic result in children with protruding ear with underdeveloped antihelix. The research was carried out in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethical Committee of the institution mentioned in the work. Informed consent was obtained from the parents of the children (or their guardians), children. No conflict of interests was declared by the authors.","PeriodicalId":166002,"journal":{"name":"Paediatric Surgery. Ukraine","volume":"108 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125099971","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":"Microsurgical subinguinal varicocelectomy in children and adolescents. Modified technique with lymphatic vessel contrast enhancement","authors":"V. Dihtiar, D. Vernihora, M. Boyko, A.V. Obertinskiy, M. Kaminska","doi":"10.15574/ps.2023.78.103","DOIUrl":"https://doi.org/10.15574/ps.2023.78.103","url":null,"abstract":"A varicocele is one of the most common causes of spermatogenesis and infertility disorders, which can be corrected. With the advent of high-quality optical operating systems, subinguinal microsurgical varicocelectomy has been added to the pediatric urologist’s arsenal. One of the most unresolved problems of using this operation in children is postoperative hydrocele and possible damage to the testicular artery due to its small size, which leads to testicular atrophy. To solve this problem, lymphatic vessel contrast with 1% methylene blue was used to verify lymphatic vessels and indirectly visualize the testicular artery. Purpose - to develop a modified technique of microsurgical subinguinal varicocelectomy with intraoperative contrast of lymphatic vessels in children; to evaluate the results of surgical treatment of varicocele using this technique. Materials and methods. The study included 65 boys aged 11 to 17 years with a confirmed diagnosis of grade III varicocele and recurrent testicular pain or testicular hypotrophy. Patients were randomized into 2 clinical groups for classical or modified varicocelectomy. The success of treatment was evaluated after 6 months. The Group I included 34 patients who underwent classical subinguinal microsurgical varicocelectomy; the Group II included 31 patients who underwent modified surgery. Results. No cases of complications and recurrence of the disease in the late postoperative period were recorded in the group using the modified technique, while in the group with the standard technique, such cases were detected in 17.6% of patients. In addition, it was found that intraoperative contrasting of lymphatic vessels made it possible to clearly identify the testicular artery in all cases in the group with the modified technique, while in the group with the standard technique it was visualized only in half of the cases. No intraoperative complications, hypersensitivity, or allergies were noted during the operation. Conclusions. A modified varicocele treatment with intraoperative lymphatic vessel contrast may be more effective and safe for patients with this disease due to vein visualization, as the artery and ductus deferens remain the only unchanged structures due to the use of a compression test and lymphatic vessel contrast. The study was conducted in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent was obtained from the patients for the research. No conflict of interests was declared by the authors.","PeriodicalId":166002,"journal":{"name":"Paediatric Surgery. Ukraine","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116003171","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":"Effect of anti-adhesion agents on cytokine profile in an experimental model of postoperative intra-abdominal adhesions","authors":"F.T. Akhmedov, H.B. Isayev, S. Guliyeva","doi":"10.15574/ps.2023.78.72","DOIUrl":"https://doi.org/10.15574/ps.2023.78.72","url":null,"abstract":"Many attempts have been made to prevent peritoneal adhesions using anti-adhesion agents, barriers and other therapeutic approaches, but their efficacy has not been widely accepted. Purpose – to determine the effects of mezogel, a mixture of metronidazole, dextran, and contrykal enriched with oxygen based on the pro- and anti-inflammatory cytokine concentration in rats with simulated postoperative peritoneal adhesions. Materials and methods. A total of 90 outbred white rats, divided into three groups of 30 animals each, underwent laparotomy and mechanical injury of the small bowel wall until a drop of blood appeared. After mechanical injury of the small bowel wall, the abdominal wound in group 1 animals (control) was closed with a layered suture technique; group 2 animals (comparison) were administered one mL of mezogel into the abdominal cavity before layer-by-layer suturing; group 3 animals (experimental) were introduced one mL of a specially prepared mixture of metronidazole, dextran, and contrykal (in a ratio of 1:1:0.1, respectively) enriched with oxygen into the abdominal cavity before the laparotomy wound was closed. Each surgical intervention lasted 15–20 minutes. On days 5, 10 and 21 of the experiment interleukin (IL) 4, IL-6, IL-10 and tumour necrosis factor alpha (TNF-α) were determined in the blood by enzyme immunoassay using corresponding test kits manufactured by Bender Medsystems (Austria). Results. The levels of the anti-inflammatory cytokines IL-4 and IL-10 increased dynamically in groups 2 and 3, while group 1 showed their decrease. The proinflammatory cytokine IL-6 and TNF-α concentration decreased in the experimental and comparison groups during the study period. On day 5 in groups 2 and 3, compared to group 1, the IL-6 concentration was reduced by 28.4% (p=0.029) and 41.0% (p=0.006), respectively. Group 3 animals had a 17.6% (p=0.043) lower IL-6 level compared to group 2 animals. On days 10 and 21 a dynamic decrease in IL-6 was observed in the animals of groups 2 and 3. Group 3 animals had the lowest TNF-α, 41.9 % (p=0.001) lower than in group 1, and 31.7 % (p=0.118) lower than in group 2. There were significant strong relationships detected between IL-10 and IL-6 in all groups on day 5 of the study. Conclusions. The administration of anti-adhesion agents, mezogel and an oxygen-enriched mixture of metronidazole, dextran, and contrykal, inhibits inflammation, which is expressed as a decrease in the concentrations of IL-6 and TNF-α. These agents lead to a negative interaction of anti-inflammatory cytokines with pro-inflammatory cytokines, in particular IL-4 with IL-6 and IL-10 with IL-6, indicating a greater prophylactic effect. The experiments with laboratory animals were provided in accordance with all bioethical norms and guidelines. No conflict of interests was declared by the authors.","PeriodicalId":166002,"journal":{"name":"Paediatric Surgery. Ukraine","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126043777","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}