LAPAROSCOPIC ECHINOCOCCECTOMY IN CHILDREN / Мэс засал

Introduction: In Mongolia laparoscopicsurgery starts 25 years ago, in our center /NCMCH/ we start laparoscopic surgery fromOctober 2013.Materials and metods: The articleanalyzes the results of treatment of 2patients 16 years old girl and 14 yearsold boy, who underwent laparoscopicechinococcectomy. Abdominal ultrasoundshowed solitary echinococcosis in VII liversegment, diameters is 9.8cm and 7.4cm.The echinococcus cysts were removed bylaparoscopy. In residual cavity of echinococcuscyst was performed laparoscopic coagulationof the inner wall of the fibrous capsulewithout drainage. After laparoscopic liverechinococcectomy postoperative period wasmuch more favorable than after traditionalechinococcectomy.Results: to evaluate the therapeutictactics and ways to improve the eliminationof residual cavities after laparoscopicechinococcectomy of liver in children.Conclusions: The hospital stay in thepostoperative period was 3 bed days.Laparoscopic echinococcectomy is goingwithout postoperative complications,without residuals, reduce the duration ofpostoperative hospital stays.

LAPAROSCOPIC NEEDLE-ASSISTED REPAIR OF INGUINAL HERNIA (LNAR) / Мэс засал

Introduction: In our hospital we didfirst laparoscopic surgery in October 2013with doctors from Samsung Medical Center,Seoul, Korea. In NCMCH we did about 3000operations per year, and about 400 of themtakes inguinal hernia. Bilateral and unilateralbig hernias has a lot of complications,like swelling, recurrence etc. Goals andobjectives:comparison between LNAR andstandard open technique of hernia repair.Calculate the outcome, hospital stay,recurrence, complications.Materials and Methods: We describeour technique and experience with thelaparoscopic needle-assisted repair of inguinalhernia (LNAR). We report retrospectively 42cases (hernias) from September 2014 toDecember 2015. We have 2 groups. In firstgroup we did standard open hernia repair in23 (54,7%)cases, in second group we didLNAR in 19 (45,3%) cases. Hernia repairis accomplished with a one port needleassistedtechnique. After identification of apatent processusvaginalis, the internal ringis encircled in an extraperitoneal plane usinga 22G-Touhy needle for placement of apurse-string suture, tied extracorporally, andburied beneath the skin. The technique wasstandardized for second group cases. Inguinalhernias were laparoscopically repaired in19patients (16 boys and 3 girls) age range1year to 16 years. All 19 cases had bilateralrepair. Mean operating time for bilateral was45 min. No complications in second group.For the first group we had 18 boys and 5girls same age range. Mean operating time1hour 20min.8 minor complications wereidentified(8 swelling) and 1 recurrence. Postoperativedata show our technique is safewith no complication. No recurrence.Results: First group: we had 18 boysand 5 girls,age range 1year to 16 years.Mean operating time1 hour 20min. 8 minorcomplications were identified (8 swelling)and 1 recurrence. Second group: we had16 boys and 3 girls, age range 1year to 16years. All 19 cases had bilateral repair. Meanoperating time for bilateral was 45 min. Nocomplications.Conclusions: In our technique meantime was shorter than in standard opentechnique. Post-operative data show ourtechnique is safe with no complication.No recurrence. Furthermore, laparoscopyobjectively identifies asymptomatic or occultcontralateral defect, uses a smaller incision,and eliminates dissection of the cordstructures potentially reducing the risk ofcord injury.

AIRWAY FOREIGN BODY DIAGNOSIS AND TREATMENT / Мэс засал

Introduction: The aim of this study was tostudy the pattern of foreign-body aspiration inthe tracheobronchial tree as well as the successrate of rigid bronchoscopy in children admittedto the National Center for Maternal and ChildHealth, Mongolia during 2012-2016.Materials and Methods: In this crosssectionaldescriptive study, the required datawere collected from the medical reports ofall children under the age of 13 years withsuspected foreign-body aspiration who wereadmitted and underwent explorative flexibleand rigid bronchoscopy during 2012-2016. Thedata was retrospective viewed.Results: Among 40 patients with aconfirmed aspiration, 57.5% (23) were malesand 42.5% (17) were females. 42.5% were1-3 years old. The most common complaints(symptoms) of patients were non-productivecough (82.5%), wheezing (52.5%) andrespiratory distress (22.5%). The mostfrequently aspirated foreign bodies were nuts(peanuts). In total, 57.5% of foreign bodieswere lodged in the right bronchial tree. In 100%of cases, the foreign body was completelyextracted by bronchoscope. The majority ofcases were admitted more than 24 hours afterthe occurrence of aspiration, and pneumoniawas the most common complication. In X-rayfindings Golitsknyekhta Yakobsona’s symptomswere in 10 /25%/ cases.Conclusion: Patient history, especiallyinitial suspicion of aspiration, coughing,wheezing and respiratory distress, can behelpful in the diagnosis of foreign-bodyaspiration. All foreign bodies were removed bybronchoscope /100%/ without complications.In X-ray findings Golitsknyekhta Yakobsona’ssymptoms were in 10 /25%/ cases.