Biomedical subjects
Publications and source records attributed to E A Ostropol'skaia.
Ectopic ureterocele associated with double kidney and ureter was observed in 95 children and orthotopic ureterocele in 9 children. Most of them were the girls (91 of 104). All the children were operated upon (135 operations). The results were studied in 78 children within the terms from 1 to 10 years. Useful practical recommendations are given.
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Within the 10 years' period, from 1968 to 1977, 8 children were renal trauma in hydronephrosis were operated upon in the Children's Surgery Clinic in LPMI. 7 patients underwent nephrectomy and one--the plasty of the pyeloureteral segment. The surgical intervention carried out immediately after trauma prevents the occurrence of complications and, sometimes, helps to preserve the kidney. The immediate and late results of the surgical treatment are good, which proves the necessity of an urgent examination and active surgical tactics in case of injury to the kidney in hydronephrosis in children.
For the recent 15 years 286 children with surgical diseases of double kidney have been under observation in the Clinic of Children Surgery of the Leningrad Pediatric Medical Institute. In 62 of them the inferior major segment of the organ was injured. In 34 cases the loss of the functional capacity of the inferior segment and atrophy of its parenchyma were revealed which served as an indication for inferior heminephrectomy. The vesicouriteral reflux into the main ureter (21 children) or both ureters (3 children) was found to be the most frequent cause of the injury of the inferior segment of the kidney. The subcapsular inferior heminephrectomy in children may be technically fulfilled and does not make problems in the separate blood supply of the segments. It is not expedient to leave a very small accessory segment of the kidney. The inferior heminephrectomy performed after strict indications gives favourable remote results.
34 children with congenital hydronephrosis, operated upon for erroneosly diagnosed acute appendicitis (17), malignant tumor (11), and ileus (8), were under observation. To prevent from unwarranted surgical interventions in dubious cases excretory urography and other x-ray and instrumental methods of examination must be used widely. After the removal of an unchanged vermiform process in children, suffering from abdominal pain, the examination of the urinary tract is indicated. Such patients should be under dispensary observation of a children's surgeon.
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During the period of 1961-1975 in the Child Surgery Clinic of Leningrad Medical Institute of Pediatrics reparative-plastic operations for the urinary bladder extrophy were performed in 39 patients. Most of children were operated upon at the age under 1 year. In 36 patients plastic reconstruction of the urinary bladder, sphincter and urethra was performed with local tissues after the Young technic in the G. A. Bairov modification. Late results of surgical treatment were studied in 26 patients within the terms from 1 to 14 years. Good results were gained in 10 patients, satisfactory--in 9, poor--in 7, one of them died.
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It is the authors' opinion that one-moment proctoplasty with careful disjunction of fistulas is the best method of treatment of newborn infants with recto-anal atresia and urinary tract fistulas. The results of the treatment in 43 cases are described.
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Within a 5-year period (1970-1974) in the Child Surgery Clinic of Leningrad Pediatric Medical Institute 63 children, aged from 2 months to 14 years (55 boys and 8 girls), were treated for the obstruction of the vesico-urethral segment. It is believed that timely performed surgical removal of the obstruction with simultaneous resection if a non-functioning kidney with the phenomena of vesico-urethral reflux allows an effective treatment of secondary pyelonephritis.
For over a 20 year period 183 children with renal injuries have been under observation (102 boys and 81 girls). As a rule, the diagnosis of such injuries was established due to roentgenological and radioisotopic studies. 131 children were treated conservatively, 52--surgically. The study of late results in renal injuries has shown that the highest incidence of complications was revealed in a group of patients in whom no revision of the kidney and pararenal space was performed. The presence of postoperative and posttraumatic complications in some patients enabled to revise the surgical policy in such injuries in favour of widening indications to surgical therapy.
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During a 20-year period the author observed 40 newborn infants with congenital hydronephrosis. In 28 patients hydronephrosis of the normally developed kidney and in 12- of the abnormal organ was noted. Twelve patients were hospitalized for developmental anomalies that necessitated urgent surgical intervention, the diagnosis of hydronephrosis in them being established at autopsy. Twenty eight children were admitted to the clinic with symptoms of hydronephrosis. All children were operated upon, nephrectomy was performed in 18 cases, in the remainder-organ-preserving and corrective operative procedures were performed.
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