Fundamentals of photodynamic therapy, clinical practice and prospects for use in pediatric surgery. Review

The paper provides a review of domestic and foreign literature on photodynamic therapy, which is mainly used by oncologists in the treatment of adult patients and is little known to pediatric surgeons. The aim of this work is to describe the history of the formation, principles and mechanisms of photodynamic therapy, the main groups of photo sensitizers, areas of clinical application and prospects for wider use in pediatric surgery. Literature sources were searched in the databases in Russian eLibrary and English Medline and PubMed. The following keywords were specified for the search: photodynamic therapy, dysplasia, metaplasia, angiodysplasia, Barretts syndrome, children. 865 papers were found, of which 66 were fully consistent with the purpose of our study and were analyzed. The data presented in the review of the literature indicate the high efficiency of the method of photodynamic therapy in the treatment of a number of diseases, mostly in oncology. In addition, the work contains theoretical calculations and separate reports on the effectiveness of the method in the treatment of dysplasia of varying degrees in children. Taking into account the minimally invasiveness of the technique, the relative cheapness of photosensitizers and equipment for generating laser radiation, it is possible to create a basis for conducting research on the treatment of children with various dysplasias, epithelial metaplasia, and vascular malformations. Another promising direction is the development of technologies for the use of photodynamic methods for the treatment of severe forms of pyoinflammatory diseases in children. In childhood surgery, there are nosological forms of diseases where the method of photodynamic therapy has the prospect of effective use. Limitations on the scope of this article do not allow for a detailed analysis of the existing experience in the use of photodynamic therapy in children, which will need to be done in subsequent works.