[Management of pediatric patients with urachal remnants].

BACKGROUND: Management of the patients with urachal remnants (URs) has been under discussion for a long time. The traditional approach with surgical removal of all urachal remnants, has been changed to a more conservative, which is preferred by many surgeons, especially in asymptomatic patients. AIM: The purpose of this study was to optimize the treatment of patients with URs, primarily for asymptomatic children. RESULTS: Our previous screening study showed that real incidence of the URs in childhood is significantly higher than it was previously stated. Based on our data and the results of literature review, we propose an algorithm for the workup and treatment of children with URs. CONCLUSION: We assume that the risk of developing complications (primarily, malignancy) was previously significantly overestimated. In this regard, we recommend conservative tactics in in most asymptomatic cases.

[Laparoscopic adrenalectomy for benign adrenal tumors in pediatric surgical practice]. / Laparoskopicheskaya adrenalektomiya pri dobrokachestvennykh novoobrazovaniyakh nadpochechnikov v praktike detskogo khirurga.

OBJECTIVE: To estimate the results of minimally invasive adrenalectomy in children and compare our data with worldwide results. MATERIAL AND METHODS: There were 65 patients aged from 3 months to 17 years with different organic diseases of adrenal glands. Children have undergone surgery for the period since 2003 to 2018. RESULTS: Incidentalomas accounted 33.8% of all resected tumors. Bilateral lesion was diagnosed in 12% of patients. The largest neoplasm (12 cm) was diagnosed in a 9-year-old child. Intraoperative bleeding occurred in 2 patients. Endoscopic surgery did not require conversion in any case. CONCLUSION: We accumulated unique experience of laparoscopic resection of benign lesions of adrenal glands. Our results are satisfactory and comparable with data of other national and foreign colleagues. Only close collaboration of pediatric surgeons and endocrinologists could lead to successful and safe treatment of these patients. Patients with suspected malignancies should receive treatment at special hospitals with oncological service.

[ULTRASONIC DIAGNOSIS OF GIRSHPRUNG ILLNESS AT CHILDREN].

Use of ultrasonic diagnostics reduces number of the low-informative, invasive and connected with beam loading procedures. Objectivity of results of ultrasonic structure of an intestinal wall depends on many subjective parameters: from the device on which examination, from the expert experience, from extent of preparation of intestines, from the applied solution for contrasting, from degree of expressiveness of a desire on a defecation is conducted when filling a thick gut.