[Economic efficacy of thoracoscopic treatment for pleural empyema in children].

Results of treatment carried out during 1989-2000 years were analyzed in 164 children with pleural empyema. Economic analysis proves that videothoracoscopic pleural cavity sanation is more beneficial in acute period in 1.7 times and in long-term period--in 1.9 times, compared with traditional method (puncture and drainage). "Cost-efficacy" analysis shows that videothoracoscopic pleural cavity sanation allows increasing of clinical efficacy in 3.6 times in comparison with traditional treatment mode. "Cost-value" analysis shows improvement of life quality in 1.2 times after application of videothoracoscopic pleural cavity sanation compared with traditional method. Cost effectiveness of videothoracoscopic pleural cavity sanation for better life quality achievement is higher in 2.3 times compared with traditional method.

[Diagnostics and thoracoscopic treatment of pleural empyema in younger children].

174 children of all ages with acute destructive pneumonia complicated with pleural empyema were treated during 10 ten years using videothoracoscopic method; among them 74 children were of younger age (43%). General principles of modern diagnostics and videothoracoscopic pleural cavity sanations were formulated. Ultrasonography and computer tomography of the chest carried out in younger children give possibilities for clear differential diagnostics with other diseases. Advantages of endosurgical treatment are proved. Indications for planned recurrent pleural cavity sanations were worked out.

[The diagnosis and surgical treatment of hydatid disease of the liver in children].

An experience with the diagnosis and surgical treatment of hydatid disease of the liver included 191 patients aged from 2 through 15 years, 26 of them had a combined involvement of the liver and lung, in 7 patients there were combined lesions with other organs. Complicated echinococcosis was noted in 25 children. Ultrasonography was given the main role in the diagnosis. Videolaparoscopic hydatidectomy of the liver was performed in 62 patients. Solitary cysts of small and medium sizes located superficially were considered as indications to operation. In patients with large and gigantic cysts of special significance was capitonnage of the residual cavity. Use of albendazole as an antiparasitic agent for the recurrent disease and a prophylactic agent after operation for multiple and combined hydatid disease of the liver was found to be sufficiently effective.

[Anesthesiologic support of videothorascopic operations in children with pleural empyema]. / Anesteziologicheskoe obespechenie videotorakoskopicheskikh operatsii u detei s émpiemoi plevry.

Total anesthesia for videothoracoscopic operations in children with pleural empyema is difficult because of severe clinical status and single-lung ventilation. Hemodynamics, blood gases, and oxygen transport were studied in 35 children aged 1.5-14 years with ASA class II-III. Total anesthesia with diprivan (propofol) in combination with fentanyl and myorelaxant mivacurium was used. The modes of single-lung ventilation depended on bronchial intubation type.

[Characteristics of general anesthesia in video thoracoscopic surgery in children]. / Osobennosti obshchei anestezii pri videotorakoskopicheskikh operatsiiakh u detei.

Videothoracoscopic operations were carried out in 54 patients aged 6 months to 14 years. Two variants of general anesthesia were used: bolus injection of fentanyl in combination with calypsol and infusion of fentanyl in combination with subnarcotic doses of fluothane. One-lung ventilation was carried out in all children. Hemodynamic status, gaseous composition of the blood, and cerebral bloodflow were monitored during general anesthesia.

[The treatment of appendicular peritonitis complicated by septic shock in childhood]. / Lechenie appendikuliarnogo peritonita, oslozhnennogo septicheskim shokom, v detskom vozraste.

The article presents an analysis of results of treatment of 39 children from 1 to 14 years of age with diagnosis of appendicular peritonitis complicated by septic shock. It was shown that complex pathogenetic treatment with controlled laparostomy, necessary compulsory or subsidiary artificial pulmonary ventilation before and after operative intervention, associated use of afferent methods allowed to decrease the number of lethal outcomes from 54.5 to 11.1%.

[The functional classification of velopharyngeal closure after uranoplasty]. / Funktsional'naia klassifikatsiia nebno-glotochnogo smykaniia posle uranoplastiki.

The new nasopharyngoscopic functional classification of palatopharyngeal joining is based on the results of examinations of 57 children with congenital uranoschisis after uranoplasty and 19 healthy children aged 5 to 14 years by nasopharyngoendoscopy. The classification defines the causes of palatopharyngeal insufficiency and for the first time takes into consideration the disagreement between the palatopharyngeal lock and articulation. The proposed classification helps select the most effective method of rehabilitation of the above patient population and helps follow up the time course of changes in the function of the palatopharyngeal lock under the effect of treatment.