The aim: To chose the best way treatment and achievement of 3-dimensional spinal correction in order to maximize its parameters to the physiological norms is a choice of the optimal surgical severe scoliotic spinal deformity correction technology. Materials and methods: Performed surgical treatments to 60 children of two patient’s groups, that were under surgical treatment for severe scoliotic spinal deformations with preliminary used halo-gravity traction and one-step correction; to establish an effective and safe protocol of the treatment for children with severe scoliotic spinal deformations (>100°). The results comparative analysis of 60 patients with severe scoliotic spinal deformations, with a two-step surgery treatments (first step – halo-gravity traction and second step – correcting spinal instrumentation) and patients with one-step correction. Patients were divided into 2 groups with 30 children in each of them. The first group treated with preoperatively HGT (halo-gravity traction) and after that a spinal instrumentation together with osteotomies (3-4 levels by Ponte; VCR (vertebral column resection) osteotomy 1 level) were performed. The second group – performed one-step spinal instrumentation with osteotomies (3-4 levels by Ponte; VCR osteotomy 1 level). Results: One-step implanted construction in children with severe scoliotic spinal deformations, compare to HGT treatment that were carried out in stages – is increasing the danger of neurological deficiency by 17%, HGT allows to make more corrections and to adjust spinal cord for the next correction treatment. . Conclusions: Halo-gravity traction as a first stage of severe scoliotic spinal deformations treatment allows to increase the mobility of the vertebral column and to adjust spinal cord step by step for the next correction treatment.

A B ST R AC T The aim of the study was to analyze the cohort of inpatient children with vascular anomalies according to the globally accepted classification introduced by the ISSVA. Methods: The study included 205 inpatient children within the time period of the years 2010-2015. Types of vascular anomalies (VAs), age of patients, diagnostic procedures, and anatomical localization of VAs were analyzed. Results: 65 patients of first year of life had vascular tumors, with prevalence of infantile hemangiomas (IHs) in 57 (87.7%) patients. 45 children had IHs localized within soft tissues, whereas 7 patients suffered from IHs of the liver, and 5 children from IHs of the respiratory tract. Most patients with soft tissue IHs were diagnosed only with ultrasound; СT or MRI diagnostics were performed on 5 (8.8%) patients, and biopsy was carried out in 2 (4.4%) children. Vascular malformations (VM) were diagnosed in 140 (68.3%) patients. Ultrasound investigation (US) was the screening method. MRI was performed to confirm the diagnosis of low-flow VM, whereas for high-flow VM CT angiography and selective angiography were useful. Venous malformations were diagnosed in 17 (12.1%) patients, and 112 (80.0%) had cystic LM, among them children under the age of 2 years prevailed. Arteriovenous malformations were diagnosed in 5 (3.8%) patients, ages 2-14 years. Conclusions: Clinical manifestations of vascular anomalies have clear age features. Among hospitalized children vascular tumors add up to 31.7% and VM -up to 68.3%.

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Purpose is to identify the factors that determine the clinical features of the LMs, their complications and the choice of treatment options. Materials and methods. 225 children with LMs who underwent treatment since 2011 to 2020 were enrolled. They were grouped according to ISSVA 2018 classification. Clinical presentation, treatment options, complications and outcomes were analyzed. One-variant analysis using Pearson’s χ2 test was used to evaluate qualitative data. Results. 214 (95.1%) patients had cystic LMs, 11 (4.9%) had combined LMs. 129 (57.3%) LMs were cervicofacial, 17 (11.9%) patients developed airways compression and 6 (4.2%) required tracheostomy. 8 (3.6%) patients developed 10 lymphatic leaks episodes, 3 were lethal. 112 (86.8%) patients with cervicofacial, 5 (11.6%) abdominal, 10 (84.6%) axillar, and 12 (92.2%) extremities LMs underwent sclerotherapy. Surgical resections prevailed in abdominal LMs, 32 (74.5%), versus 4 (3.1%) cervicofacial LMs. 10 (4.4%) patients with combined and complicated cystic LMs underwent systemic sirolimus therapy. Results of treatment were excellent in 116 (51.6%) patients, good in 82 (36.4%), satisfactory in 23 (10.2%), and unsatisfactory in 4 (1.8%), with 4 mortalities caused by sepsis (n=1) and by massive lymph leakage (n=3). Conclusions. The most life-threatening LMs complications are airways compression and uncontrollable lymphatic leakages. Several approaches were used, including surgery, sclerotherapy, and target therapy. Surgery is optional for abdominal LMs but potentially harmful in cervicofacial. Treatment of combined LM is continuous and requires a combination of different methods. 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. Keywords: lymphatic malformations, children, sclerotherapy, target therapy.

<span>The research is aimed at investigating challenges and opportunities of teaching online course in Pediatric Surgery at Bogomolets National Medical University, Kyiv, Ukraine. The participants were 42 students of the 5-th year of study. After taking the course, the students were offered to fill in 24-item 4-point Likert-type scale containing the statements regarding various issues of distance learning: gaining theoretical and practical knowledge, teacher-student and student-student interaction, the interface and content of the course, technical issues and computer literacy, academic success, development of self-directed learning skills, as well as motivation for learning, critical thinking, problem solving, self-organization and time management skills. The median value for the total cohort is 3 indicating that the majority of students gave affirmative responses. Students positively evaluated the course content and structure, interface of the platform Neuron and the interactive tools like forums, chats, videoconferencing which allowed communicating with peers and the teacher in real time and getting immediate feedback. At the same time, students experience lack of practical skills as quarantine measures don’t allow attending face-to-face lessons, they cannot interact with patients and participate in surgical operations, etc. This is a challenging task to develop medical students’ motivation, professional problem-solving and critical thinking skills in the online environment. The authors offer the recommendations to enhance the quality of online learning: use image-guided surgical simulation tools, implement interactive forms of virtual teaching, case method.</span>