Vasily Petrovich Gavrilyuk
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Stanislav Vitalyevich Kostin
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Maria Igorevna Statina
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Dmitry Andreevich Severinov
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Farkhod Sharifzhanovich Primov
Introduction. Treatment options of congenital hypertrophic pyloric stenosis (HPS) appear to be an acute issue nowadays due to the fact that this pathology is often detected in children of the first year of life - according to statistics, the incidence rate of congenital hypertrophic pyloric stenosis in children is 3:1000 live newborns. Since there are various treatment options of the given congenital pathology, there is no general consensus in the opinions of surgeons regarding the superiority of different treatment methods. Therefore, it is necessary to search for a single most relevant treatment technique for this pathology.The aim of the study was to analyze clinical outcomes for treatment of congenital hypertrophic pyloric stenosis in children with application of various surgical techniques: open pylorotomy (transverse, circumbilical incision) and laparoscopic pylorotomy.Materials and methods. The study included 67 patients, who received treatment in Kursk Regional Pediatric Hospital №2 in 2014-2018. Patients with congenital HPS were divided into 3 groups, depending on the performed surgical interventions. Group 1 included patients who underwent an open pylorotomy with transverse access, group 2 included patients who underwent an open pylorotomy with circumbilical access, and group 3 included patients who underwent laparoscopic pylorotomy. The following parameters were used to assess the efficiency of the treatment performed: the duration of the operative intervention, the duration of stay of a child in the ICU, the duration of stay of a child in the hospital, extubation time, initiation of enteral feeding, recovery rate of enteral feeding volume. The data were statistically performed using the Mann-Whitney test to determine the significance of differences between the mean values (p0.05).Results. The study results demonstrated that the shortest duration of operational intervention was observed in patients of group 3, it constituted 41,4 3,5 minutes. In addition, patients of this group spent the shortest average time in the ICU - 4,2 0,3 days - and in the hospital in general - 12,1 0,8 days; initiation of enteral feeding in patients of this group was registered in 10,8 1,2 hours and the recovery rate of enteral feeding volume was 4,8 0,5 days.Conclusions. Having analyzed clinical outcomes for treatment of pilorostenosis in the studied groups of children, it is possible to conclude that laparoscopic pyloromyotomy is preferred to open surgical interventions not only for reasons of cosmetic result, but also according to the criteria of the postoperative course of the disease in patients.
Clinical Outcomes of Rapid Versus Slow Enteral Feeding Advancements in Preterm Infants
