Применение имплантов в коррекции диафрагмальной грыжи у новорожденныхThe use of implants for surgical treatment of congenital diaphragmatic hernia in newborns Врожденная диафрагмальная грыжа (ВДГ) -патология, которая требует обязательной хирургической коррек-ции. При значительных дефектах диафрагмы, например аплазии ее купола, зачастую возникает необходимость в использовании имплантационных материалов. До сих пор нет единой точки зрения по вопросу выбора имплан-та. В статье представлены результаты сравнительного анализа лечения новорожденных (n = 40) с левосторонней ложной ВДГ. Всем пациентам была выполнена торакоскопическая пластика купола дифрагмы. По типу использо-ванного имплантационного материала детей разделили на две группы: для первой (n = 16) применяли синтетичес-кие импланты «Экофлон» («НПК "Экофлон"», Россия), для второй (n = 24) -биологические импланты Permacol (Tissue Science Laboratories, Великобритания). Результаты исследования показали преимущества биологичес-кого импланта: время операции при его использовании было меньше (106 мин против 144 мин при использова-нии «Экофлона», p <0,05); число рецидивов -также меньше (28 % против 54 %, однако p >0,05); случаев от-торжения импланта не было (при использовании «Экофлона» у двух пациентов началось воспаление, p <0,05).Congenital diaphragmatic hernia (CDH) is an absolute indication for surgical treatment. In case of extensive defects of the diaphragm, such as diaphragmatic aplasia, the use of implants is required. So far, there is no unanimous opinion on the type of the implant. The article presents a comparative analysis of treatment of 40 newborns with left pseuso-CDH. All patients received thoracoscopic repair of the diaphragmatic cupula. The patients were divided into two groups according to the type of the implant: 16 newborns received Ecoflon synthetic implants (Ecoflon Scientific and Production Complex, Russia) and 24 newborns received Permacol biologic implants (Tissue Science Laboratories, UK). The study demonstrated the advantage of the biologic implant over the synthetic one: the surgery took less time (106 minutes compared to 144 minutes with Ecoflon, p <0.05); relapses were also more rare (28 % and 54 %, respectively; however, p was >0.05); no implant rejection was observed (with Ecoflon, two patients responded with inflammation, p <0.05).Ключевые слова: новорожденные, врожденная диафрагмальная грыжа, торакоскопия, имплант, имплантационный материал, «Экофлон», Permacol
The paper describes the professional activities and merits of the pediatric surgeon Olga G. Mokrushina in celebration of her anniversary.
BACKGROUND: The right-sided congenital diaphragmatic hernia is the rare pathology. Results of diagnostics, prognosis and treatment usally published as a collection of cases. AIM: Comparition of treatment results of congenital diaphragmatic hernia with the liver as its content in dependancy of the side. MATERIALS AND METHODS: We present a retrospective analysis of 50 newborn patients with congenital diaphragmatic hernia. Patiens were divided in two groups, first with right-sided (19 patients), and second with left-sided hernia (31 patients). Groups were compared by gender and weigth. Comparition criteria was the results of prenatal and postnatal diagnostics, intraoperative data, postoperative period, complications and outcomes. RESULTS: We found predominance of prenatal diagnosis in the second group (48% vs 84%, p = 0,001). The lung-to-head circumference ratio were the same in both groups (0,52 in first, 0,46 in second, p = 0,058). Chance to use thoracoscopic approach in the second group was higer in 5,7 times (48% vs 84%). Postoperative period was easier in the group of right-sided congenital diaphragmatic hernia: artificial ventilation lasted on average 8 days (min 3; max 28) versus 11 (min 4; max 50) days in the first group (p = 0,036). Hospital stay was significantly lower in the second group 18 days (min 12; max 28), versus 50 days in the first group (min 13; max 64), p = 0,011. Recovery chance in patients with right-sided hernia was higher (45% vs 79%, confidence interval 0,0590,814). CONCLUSIONS: Every type of diaphragmatic hernia, including right-sided location, need to be the subgect of research of high compitantive center. Prognostic criteria for right-sided congenital diaphragmatic hernia require furter advanced study, wich is possible only in case of concentration of patients in the same center.
An abscess of the round ligament of the liver in children, as a result of an inflammatory process, often leading to necrosis, is an extremely rare occurrence. Formations in the round ligament of the liver must be differentiated from liver tumors, which can be diagnosed using instrumental research methods. In the available literature on the abscess of the round ligament of the liver, the authors speak about the preference for complete excision of the ligament. However, analyzing the experience (5 clinical examples are given) of the surgical clinic of the N. F. Filatov Children’s City Clinical Hospital (Moscow, Russia), the most preferable and safe are puncture and drainage of the abscess cavity from the anterior abdominal wall under visual control of manipulation using a laparoscope.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.