Biomedical subjects

A F Dronov

Publications and source records attributed to A F Dronov.

At least 19 recordsLinked to original sources

PubMed2006

[Urgent laparoscopic surgeries in children of the first year of life].

One hundred and ninety-two urgent laparoscopic operations in 179 infants (including 31 newborn infants) were performed. Indications for surgery were intestinal obstruction (108 children), acute diseases of abdominal organs (61), and gynecological diseases (10). The rate of conversion in 3 groups was 10.9, 4.6% and 0, respectively. In all the cases conversion was performed due to technical difficulties, there were no intrasurgical complications, diagnostic value of the method reached 100%. Combined laparoscopic surgeries were performed in 25.1% cases. Intestinal invagination was the most frequent cause of laparoscopy. Comparative analysis of open (28) and laparoscopic (85) desinvagination demonstrated the advantages of the latter one both during and after surgery. Laparoscopy is the useful method for diagnosis and treatment of acute abdominal disease requiring urgent surgery in infants.

Abdomen, Acute↗

PubMed2005

[Changes of motor-evacuatory function of the gastrointestinal tract after surgery in children with acute appendicitis].

A new method of computed phonoenterography (CPEG) evaluates objectively motor-evacuatory function of the gastrointestinal tract. Comparative study of changes in motor-evacuatory function of the intestine was carried out according to CPEG data in 60 children aged from 6 to 15 years after traditional surgery with Volkovich-Dyakonov incision, and after endovideosurgical appendectomy for plegmonous and gangrenous appendicitis. Inflammation of the appendix leads to inhibition of intestinal motor function. Low surgical trauma in endovideosurgical appendectomy promotes faster recovery of intestinal peristalsis according to CPEG.

Acute Disease↗

PubMed2004

[Videolaparoscopic nephrectomy and nephrouretherectomy in children].

The experience with 72 laparoscopic nephrectomies and nephrouretherectomies in children aged from 13 days to 14 years is reviewed. 51 children were under 3 years of age, 2 patients - under 1 month of life. Pathological changes of the kidneys with complete loss of function were indications for endoscopic surgery. Complex of examinations in the preoperative period included repeated USE, cystography, urography, scintigraphy, angiography. Time of surgery was 30-150 min (45 min, on the average). Blood loss during surgery was less than 50-60 ml and didn't require hemotransfusion. There were no complications during surgery. Fast recovery of physical activity after surgery, a decrease of hospital stay were seen. There were no postoperative complications and lethality. Laparoscopic nephrectomy and nephrouretherectomy are low-traumatic, safe and effective surgeries in children of any age in different diseases of the kidneys.

Adolescent↗

PubMed2003

[Laparoscopic surgery in children--current possibilities and perspectives].

Experience in use of different laparoscopic methods in 6046 children who needed urgent and elective surgeries are analyzed. Urgent surgeries were performed in 3292 children for acute appendicitis and it complications, acute adhesive intestinal obstruction, invagination, trauma of abdominal organs, pathological changes of Meckel diverticulum, urgent inflammatory and non-inflammatory gynecological diseases. In this group endosurgery was successful in 3120 (94.8%) patients, conversion to open surgery was necessary in 5.2% cases (172 patients). Laparoscopic cholecystectomy, splenectomy, nephrectomy, surgeries for cysts of parenchymatous organs, benign cysts and tumors of abdominal cavity and retroperitoneal space, varicocele, syndrome of unpalpable testes and abdominal cryptorchism were performed as elective surgeries in 2754 patients. Endosurgical methods to minimized number of complications (1.1% or 29 patients in the whole group), conversion to open surgery was necessary in 10 (0.4%) cases. Laparoscopic methods in many cases are the "gold standard" in elective and urgent surgery in children.

Adolescent↗

PubMed2003

[Comparative study of surgical and endosurgical treatment of generalized appendicular peritonitis in children].

The aim of the study was to evaluate the efficacy of endosurgery for generalized appendiceal peritonitis in children. Laparoscopic appendectomy (LA) was used as a procedure of choice in all forms of peritonitis and its complications. Original three-trocar approach and modified Gotz technique were applied. From 1991 to 2002 LA was performed in 4024 children aged from 7 days to 16 years, in 298 (5.8%) patients generalized peritonitis was diagnosed current. Prospective comparative randomized study includes 200 patients with generalized appendicular peritonitis. Contraindications were in 7% cases, rate of conversion to open surgery--2.1%. Duration of surgery was 61.7 +/- 24 min in laparoscopic group (LG) vs 73.2 +/- 31 min in open surgery group (OG). Patients of LG demonstrated earlier repair of many functions. There were no lethal outcomes. Rate of minor surgical complications was 10% in LG and 21% in OG (p < 0.05), major complications--13 and 16% (p = 0.55), respectively. There was no difference in rate of abscess formation (4%). Rate of pneumonia was 1% in LG and 3% in OG (p < 0.05), rate of critical conditions--2 and 4% (p = 0.067). Hospital stay was 15.7 +/- 3.1 days in LG and 21.2 +/- 3.8 days in OG. It is concluded that laparoscopic approach could be successfully used in more than 90% cases of generalized appendicular peritonitis. Endosurgery has many advantages over open surgery. LA demonstrates the best benefits in generalized peritonitis.

Appendicitis↗

PubMed2003

[Laparoscopy in the treatment of intestinal invagination in children].

The experience with laparoscopy in diagnosis and treatment of intestinal invagination in 142 children aged from 2 months to 11 years (study group) is reviewed. Endoscopic desinvagination was performed when conservative (pneumoirrhigoscopy) treatment was ineffective or hospitalization of patients was late. The invaginate was straightened out under video-control with two atraumatic forceps-graspers introduced into abdominal cavity and simultaneous pumping of air into the large intestine. This method permitted to cure completely intestinal invagination in 126 (88.7%) patients without laparotomy. In the control group (50 children aged from 3 months to 2 years) traditional surgery (laparotomy) was performed. Mean time of laparoscopic desinvagination was 32.6 min, time of surgery in the control group - 65 min. Postoperative complications in the study group were 5 times more rare than in the control. Mean time of hospitalization in the study group was decreased 3 times compared with the control. There were no lethal outcomes in both groups. Laparoscopic desinvagination is safe and high-effective procedure in the treatment of intestinal invagination in children.

Child↗

PubMed2002

[Diagnosis and treatment of abdominal trauma in children].

Treatment of 79 children with injuries of abdominal and retroabdominal organs was analyzed. Results of diagnosis and treatment were evaluated in 3 groups: group 1--29 children treated conservatively; group 2--20 patients in whom total hemostasis was achieved during laparoscopy; group 3--30 children who have undergone open operations. Non-invasive and minimally invasive diagnostic methods permitted to avoid surgery in 46.4% patients. Efficacy of polymeric knitted netted material and Surgicell) for hemostasis in parenchymatous organs was demonstrated experimentally in rats.

Abdominal Injuries↗

PubMed2002

[Video-laparoscopic surgeries in Meckel diverticulum in children].

From 1992 to 2001 laparoscopic diagnosis and treatment of various pathologic changes of Meckel diverticulum were carried out in 58 children aged from 3 weeks to 14 years. Bleeding from the diverticulum was in 33 patients, diverticulitis--in 21, intestinal obstruction--in 4 patients. Diagnostic laparoscopy was performed carefully with trochars of small diameters (3-5 mm). Conversion to open operation was necessary in 2 patients due to inflammation in the diverticulum and adjacent parts of the intestine. Circulatory resection of the intestine with the diverticulum in the limits of healthy tissues was performed. All 33 patients with intestinal bleeding were examined with 99mTc before surgery. Only 15 (45.4%) patients demonstrated pathologic accumulation of radionuclide in the zone of the diverticulum. Laparoscopic resection of the diverticulum was performed in 56 patients. Three methods of endoscopic resection were used: with suture device Endo-Gia-30 (31 patients), with application of Roeder's loop on the base of the diverticulum when it was 1-1.5 cm wide maximum (23), with suturing of intestine with two-layer intracorporel endoscopic suture (2). All the started laparoscopic operations were finished successfully. There were no conversions to open surgery. Mean time of surgery was 45 min. There were no intraoperative complications. In postoperative period one patient showed acute adhesive intestinal obstruction which was treated with laparoscopy. Mean hospital stay was 6.1 bed-days. There were no lethal outcomes. Cosmetic effect was excellent in all the cases.

Adolescent↗

PubMed2002

[Laparoscopic splenectomy in congenital hemolytic anemia in children].

Experience of 48 laparoscopic splenectomies in children aged from 3 to 14 years with congenital hemolytic anemia is analyzed. The main stages of laparoscopic splenectomy were the following: isolation of the inferior pole of the spleen, transection of the gastro-splenic ligament, transection of the splenic vascular trunk (with endostapler or intracorporeal ligature), dissection of the splenic ligaments, removal of the organ (with endoscopic sac or morcellator). One-stage cholecystectomy for cholelithiasis was performed in 11 patients. Time of surgery was 110-115 minutes, on the average. One-stage cholecystectomy prolonged surgery by 30-40 minutes. There were no intraoperative and postoperative complications. Conversion to open surgery was necessary in 2 cases because of endostapler failure. Patients were discharged on the 5-8th day after surgery. Physical activity restored completely 10-14 days after surgery. There were no lethal outcomes. Excellent cosmetic results were achieved in all the patients. Laparoscopic splenectomy in congenital hemolytic anemia is safe, sparing and effective endoscopic surgery in childhood.

Adolescent↗

PubMed2001

[Laparoscopic operations in acute adhesive intestinal obstruction in children].

Results of treatment of 148 children suspected for acute adhesive intestinal obstruction (AAIO) after laparoscopy are analyzed. Age of the patients ranged from 3 weeks to 14 years. There were 90 (61.4%) boys and 58 (38.6%) girls. Diagnosis of AAIO was confirmed in 129 patients (other diseases were revealed in 19 children). Laparoscopic adhesiotomy was impossible in 13 cases because of contraindications (necrosis of strangulated intestine, abscess-forming infiltration, general adhesive process). Laparoscopy was performed by specially developed technique decreasing the risk of examination in the conditions of adhesive process. The contraindications to laparoscopic adhesiotomy were developed. Laparoscopy permitted to remove the obstruction in 79.8% patients with AAIO. There was one intraoperative complication--colon injury in the area of earlier spontaneously closed fistula (laparotomy and suturing of colon's defect were performed). Postoperative period after laparoscopic operations was easier than after open operations: physical activity of the patients recovered quickly, number of postoperative complications decreased more than 3 times, hospital stay reduced more than 2 times. There were no lethal outcomes.

Acute Disease↗

PubMed2000

Laparoscopic ligation of testicular veins for varicocele in children. A report of 180 cases.

BACKGROUND: The technique of the laparoscopic treatment of varicocele in children is described, and its outcome is discussed. METHODS: A total of 180 patients from 6 to 14 years of age were studied. All of them had left-sided varicocele; 10 of them were recurrences after treatment by other methods. Varicocele was diagnosed on physical examination and confirmed by Doppler ultrasonography. The laparoscopic procedure included obligatory dissection and preservation of the spermatic artery and tinted lymphatic vessels, followed by double ligation of the spermatic veins. RESULTS: There were no intraoperative or postoperative complications and only one case of recurrence (0.6%). CONCLUSION: The suggested technique for laparoscopic varix ligation is a highly effective and reliable method for the treatment of pediatric varicocele. It provides the minimal invasiveness of the approach, effective microsurgical quality of visualization, and dissection with guaranteed preservation of the spermatic artery and lymphatic vessels, along with very low rates of complication and recurrence.

Adolescent↗

PubMed2000

[Laparoscopic appendectomy in pediatric patients: experience of 2300 operations].

The experience of 2300 laparoscopic appendectomies in children aged between 7 days and 14 years is presented. Uncomplicated forms of acute appendicitis were observed in 1611 patients (70.1%). Complicated forms were observed in 689 (29.9%) patients: general peritonitis in 196, local peritonitis--in 334, periappendicular abscess--in 122 and friable infiltrate--in 37 patients. Laparoscopic appendectomy according to F. Götz modified and adapted by us to children's age was used for all variants of the appendix location, including atypical. Optimal surgical approaches for children of early age and children over 3 years were developed. All laparoscopic interventions were completed endosurgically. Only in 15 (0.65%) patients the transition to open surgical operation was carried out on a diagnostic phase of the laparoscopic appendectomy for contraindications (solid infiltration, general peritonitis with multiple abscesses, intestine paresis with need of decompression). On comparative estimation of the laparoscopic and traditional appendectomies the indisputable advantages of the endoscopic technique are proved: more smooth course of the postoperative period, reduction of complications' number, reduction of hospital stay. Laparoscopic appendectomy is the most effective technique for the treatment of acute appendicitis complicated forms. Mean operative time was 65 min (range 42-120 min). Total amount of the postoperative complications in this group decreased almost 3 times. Frequency of such serious intraabdominal complications as acute commissural ileus decreased 3.5 times, infiltrates and abscesses of the abdominal cavity--2 times. Suppuration of the anterior abdominal wall was extremely rare. Mean hospital stay reduced almost 2 times. Intraoperative complications and lethality was not observed.

Adolescent↗

PubMed1998

Laparoscopy in the treatment of intussusception in children.

PURPOSE: The technique and outcome of minimally invasive laparoscopic treatment of various forms of intussusception in children after ineffective attempt at conservative treatment are described. METHODS: Ninety-eight patients from 2 months to 11 years of age were analyzed. RESULTS: Suggested scheme of surgical treatment using laparoscopic technique was successful in 64 patients (65.3%), and conversion to open procedure occurred in 34 (34.7%). There was no mortality or intraoperative complications in our series. CONCLUSION: Practically every form of intussusception without bowel necrosis, including the most complex forms, can be reduced now using modern videolaparoscopic equipment and atraumatic instruments.

Cecal Diseases↗

PubMed1997

[Laparoscopic surgery in gastroenterology].

The present status of gastroenterological laparoscopic surgery in Russia is comprehensively analyzed. Based on the generalized data obtained by 11 leading clinicians of the country, the authors in detail consider the feasibilities of endoscopic techniques of surgical gastroenterology, the proportion of each nosological entity in the total statistics of laparoscopic operations. A description is given of the following endoscopic interventions: cholecystectomy, choledocholithotomy, biliodigestive anastomoses, vagotomy, perforated ulcer suture, antireflux operations, gastrectomy, sigmoidectomy, right-sided hemicolectomy, rectal surgery, appendectomy, Meckel's diverticulum removal. By using the cumulative experience gained at short-term endoscopic surgery in Russia, the authors conclude that the new technique is promising during most surgical interventions in gastroenterology.

Cholecystectomy, Laparoscopic↗

PubMed1994

[Initial experience with laparoscopic appendectomy in children].

The article generalizes the first experience in successful laparoscopic appendectomies in children carried out by the method suggested by F. Götz et al. which we modified and adapted to pediatric practice. In all cases of acute appendicitis the laparoscopic manipulation began with the diagnostic stageo by performing two abdominal punctures with small-diameter trocars. Laparoscopic appendectomy was undertaken only in recognized destructive appendicitis. It was conducted 205 times in children 2 to 14 years old in various localization of the vermiform process, including subhepatic and retroperineal. Complicated forms of appendicitis were encountered in 52 patients. Nineteen children had generalized purulent appendicitis, 18 had circumscribed peritonitis, and 11 children had a loose infiltrate and signs of circumscribed peritonitis. A peri-appendicular abscess was found in the remaining 4 children. All endoscopic operations were completed successfully. In 205 endoscopically removed vermiform processes the clinical and morphological signs were in full agreement, with the exception of one case in which secondary inflammatory changes were determined in the process when the clinical diagnosis was phlegmonous appendicitis. Six complications occurred in the postoperative period: abdominal infiltrate in two patients, which was cured by nonoperative measures, and an abdominal abscess in another two patients (one was treated by laparoscopic drainage and the other by laparotomy). Early adhesive obstruction developed in two cases and was removed laparoscopically. Fatal outcomes and complications connected with laparoscopy were not encountered.

Abscess↗

PubMed1991

[Experimental premises and 1st experiences in the clinical use of antibacterial vascular prostheses under circumstances of increased risk of suppuration].

It was shown on the basis of laboratory and experimental data that created antibacterial vascular prostheses are marked, on the main, by local bacteriostatic and anticoagulative effect. It was found that heparin concentration of 3 to 500 U per 1 kg collagen causes a hyperadhesive effect on blood platelets and facilitates the formation of the primary thrombocytic thrombus. The free surface energy grows in this case from 34 +/- 0.8 to 66.3 +/- erg/cm2. The optimal thromboresistant effect occurs in heparin content of 1 U per 1 mg collagen. That this choice is correct is confirmed on examination of the inner surface of the prostheses with an electron microscope after being in the blood flow for 45 minutes. Bifurcation and linear antibacterial prostheses were used in 9 patients with a high risk of suppuration verified by cultures of discharge from ulcers and lymph nodes, and the presence of lymphangitis and lymphadenitis. The effect was positive in 8 patients, 2 of them had superficial suppuration of the operative wounds.

Animals↗

PubMed1991

[Intestinal invagination in children older than one year].

The results of treatment of 51 children at the age over 1 year with intestinal invagination were analysed. Intestinal invagination in them is caused by the organic factors, the course is atypical, clinical signs--as in other acute abdominal diseases. For timely diagnosis of intestinal invagination, it is necessary to use the roentgenological, endoscopic methods of investigation and laparoscopy. Rational tactics permitted the authors to achieve the positive results of treatment in all the patients.

Child, Preschool↗

PubMed1990

[Diagnosis and treatment of adhesive intestinal obstruction in children].

The work analyses 455 patients with acute adhesive intestinal obstruction (194 children with the early and 261 with the advanced stage of the disease). The most common causes of the obstruction were acute appendicitis, developmental anomalies of the intestine, and intestinal intussusception. Complete viscerolysis and horizontal intestinoplication by means of medical glue without application of sutures were performed in a total adhesion process, even in the acute period (34 cases). Severe paresis or paralysis of the gastrointestinal tract is an indication for its decompression. Laparoscopy was conducted in 90 children (from 3 months to 14 years of age) in suspected acute adhesive intestinal obstruction. The diagnosis was confirmed or defined more exactly in 64 patients. As the result of endoscopic operations intestinal obstruction was corrected and laparotomy was avoided in almost half of the patients. The total mortality was 1.3%.

Acute Disease↗