[Mediastinal tumors and tumor-like formations in children]. / Mediastinal'nye opukholi i opukholepodobnye obrazovaniia u detei.

Twenty-five years experience of diagnosis and results of treatment of 143 childs aged from 10 days to 15 years with sizable mediastinal formations was summarized. Benign tumor was revealed in 50 (34.96%) childs, malignant one--in 93 (65.04%). Groups of most important symptoms were suggested: generally somatic, compressive, neurological. Principal method of diagnosis of mediastinal tumor in children--the survey roentgenography of thoracic organs in two projection. Immediate and late follow-up results of operative intervention were estimated, diagnostic mistakes were analyzed.

[The abdominal cavity microflora of children with appendicular peritonitis]. / Izuchenie mikroflory briushnoi polosti detei s appendikuliarnym peritonitom.

Specific features and variability of microflora have been investigated in 75 patients with appendicular peritonitis. The patients' age was from 2 to 15. Forty-five (45) children had local peritonitis, 17, diffuse and 13 children had total peritonitis. Complications were found in 18 (49.5%) patients. Appendicular peritonitis in children was accompanied by the permanent competition and changes in microflora. Microbiological pattern depended on the process stage and varied during a rather short period. The abundance of microorganism species during local peritonitis was gradually replaced by the prevalence of Staphylococcus aureus and especially Escherichia coli under the spread inflammation. The change of microflora during post-operation period was observed in 21 patients (56.8%). In 9 patients the change was detected on the 15th--3rd day after the operation. Complications were observed in 85.7% of patients with changed microflora in the post-operation period. A conclusion was made that the prescription of the optimal antibacterial schemes of peritonitis treatment in children should be made with the account of change of bacterial agents during pathological process.

[Anaerobes in children's acute abdomen]. / Anaérobnaia mikroflora pri ostrykh zabolevaniiakh organov briushnoi polosti u detei.

Bacterial contamination of the abdominal cavity was studied in 30 children aged from 2.5 to 14 years with acute abdominal conditions. Anaerobes were detected in 63.9% of the children. It was established that on the initial stages of development of acute diseases in the abdomen the antagonism between aerobes and anaerobes was not present. 3 days and later after surgery the antagonism between aerobes and anaerobes arises which results in potentiation of the inflammatory process by either aerobes (25% of cases) or anaerobes (75% of cases). The complicated course of postoperative period in patients with acute abdomen more than in 83% of cases is due to anaerobes and in 50%--to aerobes.

[Risk factors determining the outcome of a diffuse peritonitis of appendicular genesis in children]. / Faktory riska, opredeliaiushchie iskhod rasprostranennogo peritonita appendikuliarnogo geneza u detei.

The peculiarities of pre-, intra- and early postoperative period course in 108 children, operated on for diffuse and general peritonitis of appendicitis origin, are studied. Most significant 34 prognostic factors for the disease outcome are choosed. The leading factors are the disease course duration, general condition of the patient while hospitalization, the vegetative disorders presence, the intestinal paresis degree, the biochemical inductors of stress contents, the peritoneal exudate character, the kind and composition of microorganisms in it, the character of an early postoperative period course.

[The prognosis of complicated acute abdominal disease in children]. / Prognozirovanie oslozhnennogo techeniia ostrogo zabolevaniia organov briushnoi polosti u detei.

The system of objective estimation of children severity state before and after an urgent operations conduction for the acute disease of abdominal cavity and retroperitoneal space. Three types of the disease course were delineated on the basis of 200 patients, ageing from 3 months to 15 years, examination. While stable course the conservative therapy conduction is indicated, while instable--the intensive therapy, incorporating the extrarenal depuration methods, and the operations when indicated; while the progressing, testifying the incomplete sanation of abdominal cavity--the relaparotomy and intensive therapy.

[Clinical-morphological aspects of the adhesive disease progress in children]. / Kliniko-morfologicheskie aspekty techeniia spaechnoi bolezni u detei.

The results of treatment of 60 children with complete adhesive ileus (CAI), occurring from 6 mo till 10 yrs after appendectomy conduction, were analyzed. Complex biochemical and immunological examination was conducted in 30 patients. There were 10 biopsies of parietal peritoneum examined. The obtained clinical, biochemical, immunological and morphological features may be applied for reliable prognostication of the CAI occurrence, complications course and outcome. Long observation and rehabilitational measures conduction is indicated in the patients with high risk of the peritoneal adhesive disease occurrence.

[Follow-up results of modified Glenn-Andersen operation in children with primary vesicoureteral reflux]. / Otdalennye rezul'taty modifitsirovannoi operatsii Glenna-Andersena u detei s pervichnym puzyrno-mochetochnikovym refliuksom.

The results of operative treatment of 51 patients with primary vesico-ureteric reflux followed from 6 mos to 11 yrs were analyzed. Glenn-Andersen method modification of clinic was used. Conclusion was made about the advantages of one-moment bilateral ureters transplantation over the staged treatment in children with bilateral vesico-ureteric reflux. Good result was noted in 57 (77%) observations after 74 plastic operations.

[Choice of the method of surgical treatment of hydronephrosis due to congenital stenosis of the pyeloureteral segment]. / Vybor sposoba operativnogo lecheniia gidronefroza obuslovlennogo vrozhdennym suzheniem lokhanochno-mochetochnikovogo segmenta.

The results of treatment of 139 patients with congenital pyelo-ureteric segment (PUS) narrowing were analyzed. Plastic operation was conducted in 117 of them, PUS plasty with the flap application--in 22. The prognostic significance of sign's norm deviations of the PUS diameter and length ratio as a risk factor was studied to substantiate the numerical criterion--of operation method choice. In accordance with this prognostic significance the value of Student's criterion was calculated. When the value of ratio is no more than 0.3--the narrowed part resection with subsequent ureteropelviostomy is indicated, and when this value is 0.31 or more--the PUS plasty with the flap application.

[Predicting the complications of hydronephrosis in children after surgical interventions on the pyelo-ureteral segment]. / Prognozirovanie oslozhnenii gidronefroza u detei posle operativnykh vmeshatel'stv na lokhanochno-mochetochnikovom segmente.

On the basis of mathematical analysis of the long-term results of operative treatment of 119 children with unilateral hydronephrosis caused by congenital obstruction of the pyelo-ureteral segment, the prognostically significant signs (risk factors) having unfavourable effect on the outcome of an operation were revealed. In retrospective analysis, the main types of the course of unilateral hydronephrosis in children were distinguished. In stable course, the conservative therapy is indicated, in non-stable--the intensive medicamentous therapy, or repeated corrective operation, in progressive--nephroureterectomy .