[The endotoxine aggression in the pathogenesis of postoperative complications in children with Hirsprung disease].

Signs of disseminated intravascular clotting (DIC), which were considered the laboratory sign of the subcompensated endotoxine aggression, were detected in 20 children with the Hirsprung disease, aged 3 months - 11 years. Under the influence of the operation stress the subcompensated DIC transformed to the acute decompensated reaction, which led to early complications, such as anastomosistis with tendency to the insufficiency or stenosis, enterocolitis, etc. The study revealed not only the straight connection between the postoperative complications and endotoxine aggression, but the necessity of preoperative preparation, directed on the decrease of the intestinal endotoxin level and normalization of antiendotoxin immunity.

[Optimization of laparoscopic splenectomy at children].

Treatment results of 130 patients aged 1 to 16 years with benign hematological diseases (congenital microspheric anemia--93 patients, thalassemia--18, severe idiopathic thrombocytopenic purpura--19) who has undergone laparoscopic cholecystectomy due to concomitant cholelithiasis. Optimization of surgical techniques permitted to achieve excellent functional and cosmetic results, to reduce operation time to 35-110 min (64.67+/-10.07 min on average), volume of hemorrhage to 30-110 ml (62.91+/-14.46 ml on average), to avoid intraoperative and postoperative complications. It is concluded that laparoscopy is the method of choice for the treatment of children with benign hematological diseases required splenectomy despite the age of child, spleen size, including the children with severe disorders of hemostasis system.

[Life quality of children with hematological diseases after laparoscopic splenectomy].

Problems of assessment of life quality of children with benign hematological diseases (hereditary microspheric anemia, thalassemia, idiopathic thrombocytopenic purpura) after laparoscopic cholecystectomy are discussed. The standard SF-36 scale was used before and after endoscopic surgery. It is demonstrated that after reasonable laparoscopic splenectomy almost all parameters of life quality are improved. Improvement of physical parameters argues for small surgical trauma and slight postoperative period after laparoscopic splenectomy.

[Laparoscopic operations for simple cysts of kidneys at children].

Results of treatment of 62 children aged 1 to 15 years with non-parasitic cysts of kidneys using mini-invasive laparoscopic technologies are analyzed. Laparoscopic operations with original technique have been performed at all the patients with various cysts sizes (from 3 to 13 cm across diameter) and localization (including 12 cases of peripelvic cysts). The time of surgery ranged 25 to 110 min (43 min on average); there were no conversions to open surgery, intraoperative and postoperative complications. The follow-up ranged from 1 to 3 years, there were no cases of cyst recurrence, and the functional and cosmetic results were excellent. It is concluded that laparoscopic method should be regarded as "gold standard" for the treatment of non-parasitic kidneys cysts at children that permits to achieve the stable positive results regardless of patient age, size and localization of cyst.

[Laparoscopic operation for Hirschsprung's disease in children].

Experience in the treatment of 5 children aged 6 months to 14 years with different types of aganglionosis of the colon using laparoscopic endorectal bringing down of the colon (like Coabe surgery) is analyzed. In all the cases this method permitted mobilization and resection of the intestine (to 60 cm), bringing down intact intestine on the perineum with simultaneous coloanal anastomosis. Duration of the surgery ranged from 120 to 240 min, postoperative hospital stay did not exceed 8 days. Functional and cosmetic results were excellent. The method is characterized by combination of advantages of classical Coabe operation with minimal surgical trauma of laparoscopic mobilization of the colon.