Pediatric Surgery

doi: 10.25005/2074-0581-2018-20-1-30-36
THE ROLE OF ULTRASOUND AND VIDEOLAPAROSCOPY IN DIAGNOSIS AND TREATMENT OF ACUTE SURGICAL DISEASES OF THE ABDOMINAL CAVITY ORGANS IN CHILDREN

Sh.R. Sultonov, S.S. Rasulov, M.F. Abdulloev, Kh.D. Guriev

Department of Pediatric Surgery, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan

Objective: To improve the results of diagnostic and treatment of acute surgical diseases of organs of the abdominal cavity (ASDOAC) in children.

Methods: The work is based on the study of 327 seek children with different ASDOAC at the age of 2 to 15 years. The boys were 125 (38.2%), girls – 202 (61.8%). The ASDOAC included: acute appendicitis and its complications – 163 (49.9%), pathology of pelvic organs – 139 (42.5%), intussusception – 14 (4.2%) and pathology of Meckel's diverticulum – 11 (3.3%) of cases, of which in 5 – Meckel's diverticulum was the cause of acute intestinal obstruction.

Results: Suggested therapeutic and diagnostic tactics for ASDOAC in children with the extensive use of ultrasound and video laparoscopy is rational and very effective. Sensitivity and specificity of ultrasound in the diagnosis of ASDOAC was more than 92%. Video laparoscopy is also a highly informative, relatively safe and objective method for diagnosing ASDOAC in children and in 100% of cases, it allows to clarify the diagnosis and choose the optimal tactics for surgical treatment.

Conclusions: Comparative analysis of diagnosis and treatment of ASDOAC convincingly proves that traditional methods are much inferior to video-laparoscopic operations on the severity of the operating period, the number of postoperative complications, the normalization of clinical and laboratory parameters, the reduction in hospitalization of patients, and cosmetic results, especially in girls.

Keywords: Ultrasound, video laparoscopy, acute surgical diseases of the abdominal cavity organs.

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References
  1. Adamyan LV, Dyakonova EYu, Sibirskaya EV, Poddubny IV, Glybina TM, Gafarova DA, i dr. Khirurgicheskaya taktika pri perekrute pridatkov matki u detey [Surgical tactics for torsion of the appendages of the uterus in children]. Reproduktivnoe zdorov’e detey i podroskov. 2014;4:35-41.
  2. Klimov DE, Sazhin VP, Sazhin IV, Sazhin VP. Posleoperatsionnye oslozhneniya laparoskopicheskoy appendektomii [Postoperative complications of laparoscopic appendectomy]. Endoskopicheskaya khirurgia. 2014;1:184-5.
  3. Kokhreidze HA, Kutusheva GF, Krasnogorskiy IN. Osobennosti techenia gnoynykh vospalitel’nykh protsessov pridatkov matki, oslozhnyonnykh vtorichnym appenditsitom, u devochek [Features of the course of purulent inflammatory processes of the uterine appendages complicated by secondary appendicitis in girls]. Detskaya khirurgia. 2012;1:31-4.
  4. Poddubny IV, Fitkina OA, Glybina TM. Appendikulyarno-genital’nyy syndrom u devochek [Appendicular-genital syndrome in girls]. Detskaya khirurgia. 2013;2:45-9.
  5. Phillips S, Walton JM, Chin IF. Ten-year experience with pediatric laparoscopic appendectomy – are we getting better? J Pediatr Surg. 2005;5(40): 842-5.
  6. Chetin MV, Belov VG, Akopov VG, Burtsev SV, Nikonov OA, Khlyova TN. Rol’ ul’trazvukovoy diagnostiki i videolaparoskopii u devochek s ostrym abdominal’mym sindromom [The role of ultrasound diagnosis, video laparoscopy in girls with acute abdominal syndrome]. Tolyattinskiy meditsinskiy konsilium. 2013;1-2:58-61.
  7. Ascher-Volsh J, Brodman M. Ostraya bol’ ginekologicheskogo proiskhozhdeniya [Acute pain of gynecological origin]. Reproduktivnoe zdorov’e detey i podroskov. 2010;4:21-34.
  8. Kokolina VF, Chundokova MA. Sindrom ostrogo zhivota u detey [Syn-drome of an acute abdomen in girls]. Voprosy prakticheskoy pediatrii. 2009;4(4):65-9.
  9. Lokhvitsky SV, Tseshkovsky MV, Ivanchenko AN. Endovideolaparoskopicheskie operattsii pri trudnostyakh diagnostiki v ekstrennoy abdominal’noy khirurgii [Endovideolaparoscopic surgery for diagnostic dif-ficulties in emergency abdominal surgery]. Al’manakh Instituta khirurgii im. A.V. Vishnevskogo. 2012;7(1):278-9.
  10. Razumovsky AYu, Dronov AF, Smirnov AN. Endoskopicheskaya khirurgiya v pediatrii. Rukovodstvo dlya vrachey [Endoscopic surgery in pediatrics]. Moscow, RF: GEOTAR-Media; 2016. 598 p.
  11. Sokolov YuYu, Korovin SA, Dzyadchik AV. Laparoskopiya u detey s ostroy ishemiey organov bruyshnoy polosti [Laparoscopy in children with acute ischemia of the abdominal cavity]. Uchyonnye zapiski Orlovskogo gosudarstvennogo universiteta. 2014;2(7):110-1.
  12. Stanfill AB, Matilsky DK, Kalvakuri K, Pearl RH, Wallace LJ, Vegunta RK. Transumbilical laparoscopically assisted appendectomy: an alternative minimally invasive technique in pediatric patients. J Laparoendosc Adv Surg Tech A. 2010;20(10):873-6.
  13. Saraev AR, Kurbonov KM, Polvonov ShK, Khalimov DS. Prognozirovanie iskhoda i vybor lechebnoy taktiki pri rasprostranyonnom peritonite [Prognosis of the outcome and choice of therapeutic approach at the extensive peritonitis]. Vestnik Avitsenny [Avicenna Bulletin]. 2012;3:16-9.
  14. Ikromova ZM. Somaticheskiy i ginekologicheskiy status zhenshchin reproduktivnogo vozrasta s dobrokachestvennymi opukholyami i opukholevidnymi obrazovanyami yaichnikov [Somatic and gynecological status of reproductiveage women with benign tumors and tumor like for mations of the ovaries]. Vestnik Avitsenny [Avicenna Bulletin]. 2017;19(1):7-11. Available from: http://dx.doi.org/10.25005/2074-0581-2017-19-1-7-11.
  15. Parelkar SV, Parelkar SV, Mundada D, Sanghvi BV. Should the ovary always be concerved in torsion? A tertiary care institute experience. J Pediatr Surg. 2014;49:465-8.
  16. Grapin-Dagorno C, Chabaud M. Surgical aspects of ovarian cysts and tumors in childhood. Arch Pediatr. 2008;5:778-80.
  17. Mostbeck G, Adam EJ, Nielsen MB, Claudon M, Clevert D, Nicolau C, et al. How to diagnose acute appendicitis: ultrasound first. Insights Imaging. 2016;7(2):255-63. Available from: http://dx.doi.org/10.1007/s13244-016-0469-6.

Authors informations:

Sultonov Sherali Rakhmonovich, Doctor of Medical Sciences, Head of the Department of Pediatric Surgery, ATSMU

Rasulov Said Sulaymonovich, Postgraduate Student of the Department of Pediatric Surgery, ATSMU

Abdulloev Mahmadsodik Fayzalievich, Competitor of the Department of Pediatric Surgery, ATSMU

Guriev Kholid Jomahmadovich, Laboratory Assistant of the Department of Pediatric Surgery, ATSMU

Address for correspondence:

Sultonov Sherali Rahmonovich

Doctor of Medical Sciences, Head of the Department of Pediatric Surgery, ATSMU

734003, Republic of Tajikistan, Dushanbe, Rudaki Ave., 139

Tel.: (+992) 918 629817

E-mail: sherali_1969@mail.ru

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