http://repository.usmf.md:80/handle/20.500.12710/20491 Fri, 10 Apr 2026 00:51:02 GMT 2026-04-10T00:51:02Z http://repository.usmf.md:80/handle/20.500.12710/20916 Title: Moldavian Journal of Pediatric Surgery: Pediatric Surgery International Conference “Performances and perspectives in the pediatric surgery development. 2017, No.1 Sun, 01 Jan 2017 00:00:00 GMT http://repository.usmf.md:80/handle/20.500.12710/20916 2017-01-01T00:00:00Z http://repository.usmf.md:80/handle/20.500.12710/20915 Title: Improved methods of tissue expansion in treatment of children with extensive defects of the skin Authors: Rybchenok, V.; Shcherbakova, M.; Trusov, A.; Fomina, M.; Tsapkin, A. Abstract: Introduction. Large surface skin defect closure after extensive burn trauma remains an important issue in plastic and regenerative surgery. Deficit of intact skin dictates a careful and creative approach to donor skin surfaces. Skin stretching technique using endo expansion device is a promising approach to treat large skin defects. It allows a significant reduction of scar surface area. Application of this technique for free dermal transplants allows receiving skin grafts similar to normal skin. The goal of this approach is to form a full-thickness skin flap of a desired size in cases where traditional skin donor surface areas are limited or not available. The resulting skin flap could be used on various body parts. The purpose of the study is to further characterize and advance the method of skin surface expansion for auto-grafting. Purpose: to increase the potential of the expansion dermotension. Materials and methods. In 2006-2017 years 25 patients age 4 years to 17 years with large-surface skin defects were treated using skin stretching technique. 24 patients had burn trauma and one patient had a trauma related to a car accident. All patients had scar deformations and various degrees of contractures, which were associated with significant limitations in their everyday life. Either large (120 mm x 45 mm) or small (90 mm x 45 mm) skin stretching devices were placed endoscopically. Radio knife “Surgitron” and hydro knife “Versa jet” were used for incisions. Skin stretching was achieved by gradual expansion of latex ballooning devices using 0.9% Normal Saline over a period of 4-8 weeks. Various body areas were used as a donor site for skin stretching based on individual cases- back, lateral chest and abdomen. 4 patients received local intra dermal injections of botulinum toxin at the site of implantation of skin expansion device 3-4 days prior to the procedure. Results. Using skin stretching devices we were able to get full-thickness donor skin surfaces ranging from 60 square centimeters to 300 square centimeters. Wounds were closed using adjacent skin tissue. Small linear normotrophic scars were formed as a result. 4 patients had some degree of peripheral necrosis at the edges, which were successfully treated using conservative methods. Scar deformations and contractures were corrected in all patients. Conclusions. Skin stretching technique has been proven to be a useful method in managing large surface skin defects in pediatric patients with various burn trauma, scar contractures, other traumatic causes of skin defects. Skin stretching technique allows receiving a full-thickness auto skin graft of a desired size similar to normal skin. This method solves a problem with lack of skin auto-graft for closure of large surface wound areas. Sun, 01 Jan 2017 00:00:00 GMT http://repository.usmf.md:80/handle/20.500.12710/20915 2017-01-01T00:00:00Z http://repository.usmf.md:80/handle/20.500.12710/20914 Title: Value of early diagnosis of diseases of the urinary system at newborns and children of the first months of life Authors: Rushanyan, R.G.; Akselrov, M.A.; Chernova, A.L.; Stolyar, A.V.; Yemelyanova, V.A.; Malchevsky, V.A. Abstract: Relevance. The number of children of early age with congenital urological pathology, in particular obstructive uropathy, steadily grows and is registered at 5–14% of newborns. The aim of research: to improve results of treatment of children with urological pathology by improvement of diagnostics and optimization of terms surgical treatment. Patients and methods. On the basis of department of children’s surgery of the Tyumen State Medical University the analysis of results of treatment of 117 children with obstructive uropathy (boys-75 (64%), girls - 42 is carried out (36%). Patients were divided into two groups. The first group made 44 (38%) the child at which pathology of an urinary system was revealed after the birth, already at accession of complications (temperature increase of a body, a leukocyturia and a gematuriya, pains in lumbar area). Age range of these patients made from 1 to 15 years. The second group - 73 (62%) newborns. Pathology at them was revealed in antenatal perid by means of a ultrasound sonography. Treatment to these patients was carried out from the first days of life. Results. Early detection of this pathology and timely surgery before emergence and accession of a secondary infection of an urinary system improved results of treatment of these patients, having reduced quantity of complications from 28.3% to 1,4%. Conclusion. Early detection of this pathology created prerequisites for early surgery before emergence and accession of a secondary infection of an urinary system. This circumstance is decisive in prevention of postoperative complications, and also the satisfactory immediate and remote results of treatment. Sun, 01 Jan 2017 00:00:00 GMT http://repository.usmf.md:80/handle/20.500.12710/20914 2017-01-01T00:00:00Z http://repository.usmf.md:80/handle/20.500.12710/20913 Title: Achalasia of the esophagus in children Authors: Razumovsky, A.Yu.; Mitupov, Z.B.; Alkhasov, A.B.; Bataev, S.M.; Stepanenko, N.S.; Zadvernuk, A.S.; Chubko, D.I.; Petrov, A.P.; Ignatiev, R.O. Abstract: Purpose: Achalasia of the esophagus is a rare disorder in children, its symptom can mimic common childhood illnesses. In this study, the tactics of managing children with the corresponding pathology and evaluating the effectiveness of ongoing surgical treatment at the Filatov Children Hospital are considered. Materials. From 1991 to 2016, inthe Filatov Children Hospitalwas treated 39 patients with achalasia. Since 2011, all patients (27 cases) have undergone laparoscopic Hellercardiomyotomy with Dorfundoplication. The average age was 9.9 (4-15) years. The most frequent symptoms were vomiting (81%) and dysphagia (70%). Weight loss was observed in 48.1% of patients and chronic cough in 25%. Results. All children underwent laparoscopic Hellercardiomyotomy with Dorfundoplication. Intraoperative complication - damage to the mucosa of the esophagus occurred during cardiomyotomy in 2 cases (7.4%), which were cured during the laparoscopic procedure. There were no open procedures. Six (22.2%) required repeated intervention: pneumatic dilations (n = 2), balloon dilatation (n = 2) and re-surgery (n = 2). Conclusions. In our study, laparoscopic Hellercardiomyotomy in the case of achalasia of the esophagus is effective in 77.8% of children. We recommend this operation with Dorfundoplication, and believe that it is the operation of choice in the treatment of achalasia in children. Sun, 01 Jan 2017 00:00:00 GMT http://repository.usmf.md:80/handle/20.500.12710/20913 2017-01-01T00:00:00Z