[Surgical Short Stay Unit at a Metropolitan Children's Hospital].

Currently, the development of day care hospitals is determined by the need to improve medical, social and economic efficiency of medical institutions, and high demand among population for this type of medical service. Our foreign colleagues' experiance shows that the volume of planned surgical care in such structural units reaches 80%. The article analyzes the results of the Surgical Short Stay Unit at the Moscow Morozov children's hospital. From February 2017 to December 2018, 5684 surgical interventions were performed in the Department, 1073 of them were performed via the laparoscopic method in patients with inguinal hernias, varicocele, and non-palpable testicular syndrome. The length of patients' stay at the hospital averaged 6-8 hours. A unique algorithm of anesthetic support using 2-lumen laryngeal masks without muscle relaxants and narcotic anesthetics was performed. Only 1 patient needed to be transferred to a 24-hour hospital from the Unit. There were no surgical complications. The organization of the short stay unit in Morozov Moscow Children's Hospital allowed to radically improve the availability of minimally invasive modern medical care for children, to free highly specialized round-the-clock surgical beds, and to increase economic benefits for the medical institution.

[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.