Paediatric Surgery. Ukraine最新文献

{"title":"Remote consequences of pyloromyotomy in children","authors":"B. Y. Malovanyy, A. Pereyaslov","doi":"10.15574/ps.2023.78.66","DOIUrl":"https://doi.org/10.15574/ps.2023.78.66","url":null,"abstract":"Hypertrophic pylorostenosis is one of the most frequent causes of vomiting in newborns requiring surgical intervention. While the intraoperative complications and immediate results of pyloromyotomy are widely reported in the literature, the remote consequences of this intervention, especially depending on the method of correction, are not well understood and contain contradictory results. Purpose - to study the remote consequences of pyloromyotomy depending on the method of surgical correction - open (OMPT) or laparoscopic pyloromyotomy (LMPT). Materials and methods. The primary assessment of long-term outcomes was performed by analysing the answers to the questions of the Diagnostic Questionnaire for Paediatric Functional Gastrointestinal Disorders, which was sent to 246 patients and their parents; responses were received from 169 (68.7%) respondents, who were included in the study. Re-hospitalisation was required in 57 (33.7%) children who underwent X-ray examination, fibrogastroscopy and ultrasonography. Statistical processing of the study results was performed using the software StatPlus: mac, AnalystSoft Inc. (version v8). Results. The average age of patients involved in the study was 8.5±0.3 years (range of fluctuations - from 2 to 18 years old). Among the respondents, 132 (78.1%) children underwent OPMT, and 37 (21.9%) children underwent LPMT. No complaints were expressed by 102 (60.4%) children, including 81 (61.4%) children after OPMT and 21 (56.8%) after LPMT (p=0.6152). The main complaint in children after pyloromyotomy, which required re-hospitalisation, was chronic abdominal pain, as indicated by 38 (22.5%) of the respondents. There was no correlation between the occurrence of chronic abdominal pain and the age at which hypertrophic pylorostenosis was diagnosed (R=0.183, p=0.2588), the duration of the disease (R=0.079, p=0.6275) and the child's body weight at the time of the intervention (R=0.048, p=0.768). Functional disorders of the digestive tract were diagnosed in 15 (8.9%) children. In 24 (14.2%) children, a slowdown in barium passage through the intestine was detected, which, in combination with periodic pain, indicated chronic adhesive disease. Fibrogastroscopy revealed duodenogastric reflux in 18 (10.7%) children, which in 5 (2.96%) patients was combined with pylorus insufficiency and in 12 (7.1%) with gastritis, and in 17 (10.1%) children gastroesophageal reflux was diagnosed. Conclusions. Thus, in the long term after pyloromyotomy, 33.7% of children required re-hospitalisation due to various pathologies of the gastrointestinal tract. Duodenogastric and gastroesophageal reflux and chronic adhesive disease were most often detected in the long term after pyloromyotomy, and the frequency of their occurrence did not depend on the method of surgical intervention. 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 institut","PeriodicalId":166002,"journal":{"name":"Paediatric Surgery. Ukraine","volume":"34 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":"116706852","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":"Intestinal and mesenterial cystic lymphatic malformations in children: clinical course features and treatment tactics","authors":"D. Diehtiarova, I. Benzar, A.H. Rusyn, O. Godik","doi":"10.15574/ps.2023.78.79","DOIUrl":"https://doi.org/10.15574/ps.2023.78.79","url":null,"abstract":"Lymphatic malformations (LMs) - are congenital vascular malformations caused by abnormal embryologic development of the lymphatic system with variable clinical manifestation. Abdominal LMs account approximately 5% of all LMs. The main treatment option for abdominal LMs is surgical. Purpose - to analyze our experience in intestinal and omental LMs diagnosis and treatment, to reveal factors that could influence the complications occurrence risks, that could improve abdominal LMs treatment results in children. Materials and methods. Among 240 pediatric patients, who underwent cystic LMs treatment in a period from December 2012 to July 2022, 43 (19.1%) were diagnosed abdominal and retroperitoneal LMs. 18 (41.8%) patients with intestinal and mesentery affection were included into the study group. Median follow up was 20.7 (95% CI: 12-27) months. Results. Male patients predominated in the study group. Median age at admission was 2.5 (95% CI: 0.75-5) years. 12 (66.6%) had an emergency admission. In 7 (38.8%) children LMs were complicated by intestinal obstruction (n=5; 71.4%), intracystic bleeding and LM cyst infection were observed in n=1, 14.3%) cases both. Surgical treatment was applied in 16 (88.8%) patients, among which 7 (43.7%) underwent laparoscopy. In 4 (25%) cases conversion to laparotomy took place, 5 (31.3%) underwent laparotomic surgeries. No recurrences after surgical treatment were observed. Systemic therapy with mTOR-inhibitors was prescribed in a child with symptomatic total mesentery affection, observational tactics was chosen for asymptomatic child. Conclusions. Intestinal and mesenterial LMs can be asymptomatic or manifest complications, which were observed in 7 (38.8%) children of our group. Macrocystic intestinal LMs are of higher risks of complications development (р=0.0236). Surgical treatment is effective for local intestinal and mesentery affection, excellent treatment result was achieved in 94.1% of patients. In cases with total mesentery affection mTOR-inhibitors systemic therapy is the treatment of choice. 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":"210 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":"123866167","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":"Сlinical experience of using a standardized national lung ultrasound protocol in children for screening examinations","authors":"I.O. Baryska, G.P. Hitryi, T. Levchenko, S. Yaroslavska, O.V. Ladonko, V. Prytula","doi":"10.15574/ps.2023.78.42","DOIUrl":"https://doi.org/10.15574/ps.2023.78.42","url":null,"abstract":"The article highlights the use of ultrasound diagnostics (US) of the lungs for screening examination of paediatric patients, as it allows for a quick differential diagnosis, a comprehensive assessment of the course of the disease, especially in doubtful cases, a reduction in the time required for examination of patients, and timely adjustment of treatment. Screening ultrasound, combined with physical examination methods, is a kind of «sonographic stethoscope», the use of which simplifies, shortens and improves the diagnostic process and the choice of treatment tactics. Purpose - to prove the feasibility of using a standardised lung ultrasound protocol for screening paediatric patients with symptoms of respiratory system disorders in outpatient and day hospital settings. Materials and methods. The study involved 137 patients aged 4 months to 12 years old. The data of clinical picture, physical and laboratory examinations, computed tomography and lung radiography, semiotics of lung lesions were analysed. For the study, we used stationary ultrasound devices of high and expert class «Samsung» (South Korea), «Mindray» (China), «GE» (USA), which are equipped at the Kinder Clinic, Kyiv, and the National Specialised Children’s Hospital «OKHMATDYT», Kyiv. For paediatric age, a 4-12 mHz linear sensor was mostly used. Results. A total of 137 patients aged 4 months to 12 years were examined. Pneumonia was confirmed in 52 (38%) patients. Of the 137 patients, the polymerase chain reaction test was positive for COVID-19 in 11 (8%) cases and for influenza A in 3 (2.2%) cases. No signs of pneumonia were noted in 85 (62%) children, but 59 (69.4%) of the 85 patients had interstitial syndrome at the B+ and B++ levels, especially expressed in loci I-IV-VII. In the remaining 26 (30.6%) patients, lung ultrasound did not reveal any changes that would indicate disease. They also did not have clear clinical manifestations of acute respiratory viral infection. Separately, we analysed 7 doubtful cases (5.1% of the total) with no or one of the listed diagnostic criteria. Conclusions. This method is recommended for effective lung screening as an «ultrasound stethoscope» for paediatric patients to detect lung pathology, in particular, in the case of latent disease, and to reduce radiation exposure. It is a priority for dynamic monitoring of the course of the disease and the effectiveness of therapeutic tactics. This diagnostic method is affordable and effective for use by doctors of various specialties. 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":"68 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":"132883582","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":"Results of the application of an improved prognostic and therapeutic algorithm for the provision of radical surgical care to patients with mechanical jaundice of benign and malignant genesis","authors":"P. Muraviov, B. Zaporozhchenko, S. Khimich, I. Borodaev, V. Shevchenko","doi":"10.15574/ps.2023.78.88","DOIUrl":"https://doi.org/10.15574/ps.2023.78.88","url":null,"abstract":"The problem of improving the results of surgical care for patients with mechanical jaundice syndrome as a complication of pancreaticobiliary cancer and chronic pseudotumor pancreatitis is still being discussed. Purpose - to improve the results of radical surgical care for patients with pancreaticobiliary cancer and chronic pseudotumour pancreatitis complicated by mechanical jaundice syndrome. Materials and methods. The results of surgical treatment of 272 patients with mechanical jaundice syndrome were analyzed. The main group included 112 patients who were treated with our own developed prognostic and therapeutic algorithm. The comparison group included 160 patients who underwent preoperative preparation outside this algorithm. Results. Almost all the patients in the main group had single nucleotide genetic mutations in the PRSS 1 (Arg122His), SPINK 1 (Asn34Ser), TNF (G308A) and CFTR (Phe508del) genes. In patients of the main group, according to ultrasound elastography, the density of pathological focus for pancreatic cancer was 7.5±0.8 units, and for chronic pseudotumour pancreatitis - 5.6±0.5 units (p<0.05). The most significant differences were observed in the frequency of pancreaticodigestive anastomosis failure (2=6.95; p=0.008) and in the frequency of bleeding in the postoperative period (2=4.29; p=0.004). The amount of life-threatening postoperative complications was 42 (37.5%) cases in the main group and 102 (63.8%) cases in the comparison group (2=18.22; df=1; p<0.0001). In the main group 7 (6.3%) patients died, in the comparison group - 19 (11.9%). Conclusions. Prevention of the development of immediate postoperative complications in patients with focal pathology of the pancreatobiliary zone against the background of mechanical jaundice is achieved by combining molecular genetic studies with the determination of the patient's phenotype, ultrasound fibroelastography and mathematical modelling of patient status. 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":"31 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":"124511876","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 the polymorphism of the ADRB2 molecular structure and its influence on the development of chronic postsurgical pain in children","authors":"Y. Semkovych, D. Dmytriiev, R. Chornopyshchuk, R. Kozovyi, N. Chornopyshchuk","doi":"10.15574/ps.2023.78.9","DOIUrl":"https://doi.org/10.15574/ps.2023.78.9","url":null,"abstract":"Introduction. Pain is a signal to any aggression that leads to cellular damage and requires a defensive response. Uncontrolled acute perioperative visceral pain can lead to the development of pain chronicity. By studying the characteristics of chronic pain, some scientists have identified relationships with single-nucleotide polymorphisms of the beta2-adrenergic receptor (ADRB2) gene. Purpose - to study the dependence of pain expression in the postoperative period in children on the polymorphism of the molecular structure of the ADRB2 receptor. Materials and methods. The study involved 42 children (20 boys and 22 girls) aged 7 to 18 years who were treated in the surgical department in 2020-2022 for acute appendicitis and peritonitis. Results. Based on the results of examining all the subjects under study, 13 children had the Arg16Gly polymorphism, 15 children had the Arg16Gly polymorphic variant, and 14 children were diagnosed with the homomorphic Gly16Gly polymorphism in the ADRB2. The data obtained confirmed the trend of the preliminary analysis and proved better body response to pain relief and reduced pain intensity in individuals with the Arg16Arg variant of the ADRB2. Analysis of the dependence between the polymorphism of the ADRB2 molecular structure and Visual Analogue Scale (VAS) scores in children in the postoperative period proved that the presence of Arg in the receptor phenotype had a strong negative correlation with the VAS score on discharge day (r=-0.822, p<0.001), while the presence of Gly in the receptor phenotype had a strong positive correlation with the Visual Analogue Scale score on discharge day (r=0.814, p<0.001). In regression analysis, the presence of Gly in the receptor phenotype was associated with a 1.917-fold increase in the VAS score at hospital discharge (OR: 1.917; 95% CI: 1.448-2.385; р<0.001). Conclusions. The presence of the homomorphic Arg16Arg variant of the ADRB2 in children who underwent anterior abdominal wall surgery was accompanied by rapid response to analgesics. 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":"40 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":"127384345","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 effect of permanent stress caused by the war in Ukraine on the condition of patients after portal esophageal bleeding","authors":"V. Petrushenko, D. Grebeniuk, R. Buriak, Y. Hrytsun, H. Palahniuk","doi":"10.15574/ps.2023.78.50","DOIUrl":"https://doi.org/10.15574/ps.2023.78.50","url":null,"abstract":"Purpose - to assess the impact of permanent stress caused by the war in Ukraine on the condition of patients after portal esophageal bleeding. Materials and methods. The study included 37 patients with a confirmed diagnosis of liver cirrhosis complicated by portal hypertension and esophageal variceal bleeding. The Group 1 included patients who underwent endoscopic band ligation of bleeding varices and partial splenic artery embolization 1 month after the bleeding. The Group 2 included patients who underwent only endoscopic band ligation. Patients of the Groups 1 and 2 underwent all stages of the study before the start of the war in Ukraine. The Group 3 included patients who had a bleeding episode within 1 month before the start of the war. In dynamics, the levels of laboratory indicators of the functional state of the liver and the quality of life according to the SF-36 questionnaire of patients were evaluated. Results. In the Group 1, there was a reliable progressive improvement of all studied indicators over time. In the Group 2, there was a reliable improvement of all indicators in the period between the first and second visits, with their subsequent slight negative dynamics, but without statistical reliability. In the Group 3, the dynamics of changes in all studied laboratory indicators on the first four visits generally repeated that in the Group 2. On the fifth visit, the numerical values of almost all studied indicators were higher than the initial values, although the differences were not statistically significant. As for the quality of life, on the second visit there was a significant increase in the indicators of the physical component of health and a decrease in the indicators of the psychological component of health. Subsequently, a decrease in the values of both indicators in comparison with the values on the second visit was observed. On the fifth visit, there was an increase in indicators of the psychological component of health. Conclusions. The stay of patients after portal esophageal bleeding in a state of permanent stress leads to the deterioration of the psychological component of health from the very beginning of the action of stressful factors, followed by a gradual decrease in the physical component of health. The cumulative effect of permanent stress leads to the objectification of changes in the physical condition of such patients, which is manifested by the deterioration of indicators of the functional state of the liver. 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 institution mentioned in the paper. 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":"22 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":"115617586","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":"Infusion and transfusion therapy for victims with penetrating head wounds in preparation for aeromedical evacuation","authors":"G. Khytryi, Yurii Ukhach","doi":"10.15574/ps.2023.78.25","DOIUrl":"https://doi.org/10.15574/ps.2023.78.25","url":null,"abstract":"Purpose - to assess the effectiveness and scope of infusion and transfusion therapy for wounded with penetrating head wounds at the stage of stabilization and preparation for aeromedical evacuation. Materials and methods. A retrospective analysis of the medical records of 122 servicemen who were injured during combat missions was conducted. The Group 1 included 52 servicemen with mine blast thoracoabdominal wounds; the Group 2 - 40 servicemen with penetrating head wounds; the Group 3 - 30 servicemen with combined penetrating head wounds and mine blast thoracoabdominal wounds. The study shows the median and interquartile range of the values of the studied indicators. The Kruskal-Wallis test was used to analyze the data, and a posteriori comparisons were made using the Dunn’s test. Results. A retrospective analysis of the medical records of 122 servicemen who were injured during combat missions was conducted. The total volume of haemotransfusion in the victims of the Group 1 was 1525 (445-2325) ml, in the Group 2 - 0 (0-0) ml, in the Group 3 - 1150 (0-1800) ml. The volume of infusion therapy at the stabilization stage in the Group 1 was 3150 (2450-4200) ml, in the Group 2 - 1200 (800-1400) ml, in the Group 3 - 1400 (880-3200) ml. In the Group 1, the shock index (SI) decreased to 0.67 (0.61-0.71), in the Group 2 - to 0.58 (0.55-0.66), in the Group 3 - to 0.66 (0.61-0.71). The correlation analysis in the Groups 1 and 3 revealed a negative correlation of medium severity between the amount of haemotransfusion and the change in SI (ρ=-0.353 at p=0.01; ρ=-0.525 at p=0.003). Conclusions. Infusion and transfusion therapy in the prescribed volumes allowed to reduce the rate of SI in wounded servicemen by 23.7% (95% CI: 19.2-29.5%). Victims of the Group 3 required a greater volume of infusion and transfusion therapy, which affected the time required to prepare for aeromedical evacuation. 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 institution mentioned in the paper. 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":"97 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":"117317027","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 complete tubular doubling of the colon associated with congenital anorectal malformation - rectovestibular fistula and anomalies of the urogenital system","authors":"O.P. Dzham, O. Sliepov, V. Soroka","doi":"10.15574/ps.2023.78.119","DOIUrl":"https://doi.org/10.15574/ps.2023.78.119","url":null,"abstract":"Doubling of the colon is a rare, complex congenital anomaly, both in terms of diagnosis and in the choice of treatment tactics. Patients with this pathology need a thorough comprehensive examination to determine the type of doubling (cystic, diverticular or tubular) and to diagnose possible associated malformations, in particular, the genitourinary system. Anorectal duplications in most cases are tubular doublings that end in distal fistula / fistula on the perineum, or in the genitourinary system. Surgical treatment of this malformation requires a differentiated approach for each patient. Until now, various methods of surgical correction of this defect are used: dissection of the common wall, resection of only the duplicate section, resection of both parts of the double colon, mucosectomy of the duplicate intestine. Their main task is to maximize the anatomical integrity of the colon, with adequate blood supply. In the postoperative period, patients definitely need constant monitoring and rehabilitation treatment. Purpose - to analyze the methods of correction of this defect and evaluate their effectiveness; to present a case of our own staged surgical treatment of complete tubal doubling of the TC associated with congenital anorectal malformation - rectovestibular fistula and anomalies of the genitourinary system. Our proposed phased surgical treatment of complete tubular doubling of the colon, with rectovestibular fistula, allowed to normalize of the motor-evacuatory function of the formed main intestine and the retaining function of the anal sphincter apparatus with good functional results. 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":"13 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":"126450241","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 correction of congenital kyphosis in children. Clinical case","authors":"A. Mezentsev, D. S. Petrenko, D. Demchenko","doi":"10.15574/ps.2023.78.135","DOIUrl":"https://doi.org/10.15574/ps.2023.78.135","url":null,"abstract":"Congenital kyphosis occurs as a result of a disorder of vertebral formation or segmentation. There are a number of scientific papers that evaluate and compare various methods of surgical treatment of patients with congenital kyphosis, as well as analyze complications in this group of patients. In the current literature, preference is given to methods with more aggressive correction of angular kyphotic deformity, in particular, corrective spinal osteotomies and various types of vertebrectomy. These methods can achieve significant deformity correction, but have a high risk of complications associated with fractures of the fixation rods in the long-term postoperative period. Purpose - to present a clinical case of surgical treatment of a patient with congenital kyphosis, which allowed to achieve significant correction of the deformity and reduce the number of complications associated with the instability of the metal structure. The clinical case describes the treatment of a 16-year-old patient with an active Th11 wedge-shaped halve vertebrae using the method of decancellation the latter and fixing the spine with a transpedicular metal structure. The peculiarity of the surgical intervention is the use of rib fragments as an autograft to form a posterior spondylodisc. Conclusions. The use of rib fragments as an autograft creates conditions for the formation of a posterior bone block, which reduces the risk of fracture of the fixation rods in the long-term postoperative period. 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":"113 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":"124690208","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":"First experience of implantation of diaphragm pacemakers in infant with bilateral diaphragmatic paralysis","authors":"O.M. Leniv, A. Pereyaslov, R.Y. Kovalskyy, L. Hyzha, O. Nykyforuk, R. Dats","doi":"10.15574/ps.2023.78.127","DOIUrl":"https://doi.org/10.15574/ps.2023.78.127","url":null,"abstract":"Phrenic nerve injury is not frequent, but well recognized complication of birth trauma caused by brachial plexus injury. Diaphragmatic paresis is usually unilateral, and cases of bilateral damage are rare. Diaphragmatic paralysis led to development of severe respiratory disorders, which required the prolonged intensive care, often with the applying of mechanical ventilation. Although is it possible the spontaneous restoration the function of the diaphragm, this requires the long-term of respiratory support. The general accepted guidelines of the treatment of infants with paresis/paralysis of diaphragm is absent. Diaphragmatic plication considered as the main surgical method of treatment. By that, diaphragmatic plication not always had a positive effect. The aim of the study was to present new possibility in the treatment of infants with bilateral diaphragmatic paralysis. Clinical case. We presented the first experience of transthoracic implantation of diaphragm pacemaker in infant with bilateral diaphragmatic paralysis. The newborn was hospitalized with the respiratory disorders’ syndrome. The paresis of both hemidiaphragms was reviled on chest X-ray. For 7 months child required the mechanical ventilation, due to unsuccessful attempts to transfer the child to spontaneous breathing caused the decrease of saturation. With the aim to restore spontaneous breathing, the implantation of diaphragm pacemaker, under the thoracoscopic control, was performed initially at the right side and next at the left side. The effectiveness of the treatment was confirmed by the electroneuromyography and ultrasonography. Conclusions. Implantation of the diaphragmatic pacemaker my be the method of treatment in infants with bilateral diaphragmatic paralysis. 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":"11 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":"114727118","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}