Year 2018 Vol. 26 No 2

EXCHANGE OF EXPERIENCE

M.A. AKSELROV1,2, V.A. EMELYANOVA2, S.N. SUPRUNEC 1,2, T.V. SERGIENKO2, I.G. ANOXINA2, N.V. KISELEVA2

FIRST EXPERIENCE OF LAPAROSCOPIC DUODENO-DUODENAL ANASTOMOSIS IN NEONATES WITH HIGH INTESTINAL OBSTRUCTION CAUSED BY ANNULAR PANCREAS

Tyumen State Medical University1,
Regional Clinical Hospital ¹ 22, Tyumen,
The Russian Federation

In the Russian Federation, congenital malformations occupy the second place in the structure of infant mortality. Improving operational tactics, anesthesia and post-operative care is an important goal in reducing mortality from this group of diseases. Reduction of the traumatic nature of a surgical intervention directly correlates with the course of the postoperative period. The introduction of a minimally invasive, laparoscopic method of performing the operation must optimize the postoperative period. But volumetric laparoscopic interventions in newborns are difficult. Therefore, the description of laparoscopic treatment of the duodenal obstruction caused by the annular pancreas is sporadic. In the Children’s Surgery Clinic of Tyumen State Medical University, 5 newborns with the duodenal obstruction, caused by the annular pancreas, were operated with the use of laparoscopic technique. The course of the disease in all children was typical. The congenital malformation of development was corrected by the laparoscopic formation of duodeno-duodenal anastomosis. The postoperative period was more uneventful in these children compared with those operated openly. The operation technique and the postoperative course did not differ significantly. Enteral nutrition was started within a week after the operation in all children. After laparotomy, the passage through the gastrointestinal tract is restored not earlier than 10, often 14 days. It is associated with quicker stopping of the inflammation in the anastomosis zone. The article describes in details one clinical case. The technique of laparoscopic duodeno-duodenal anastomosis, when a surgeon has the experience of working with newborns, is a safe, effective technique and can be a choice of surgical treatment of congenital duodenal obstruction caused by the annular pancreas.

Keywords: congenital duodenal obstruction, annular pancreas, duodeno-duodenal anastomosis, laparoscopy, newborn
p. 248-253 of the original issue
References
  1. Poroki razvitiia [Elektronnyi resurs]. Inform Biul. 2015 Apr;(370). Available from: http://www.who.int/mediacentre/factsheets/fs370/ru. (in Russ.)
  2. Goleva OP, Bogza OG. Sostoianie mladencheskoi smertnosti v sovremennoi Rossii. Zhurn Nauch Publikatsii Aspirantov i Doktorantov. 2013;(3):154-57. (in Russ.)
  3. Rossiiskii statisticheskii ezhegodnik 2016. Federal’naia sluzhba gosudarstvennoi statistiki [Elektronnyi resurs]. Available from: http://www.gks.ru/bgd/regl/b16_13/Main.htm. (in Russ.)
  4. Cochran WJ. Duodenal Obstruction. Available from: http://www.msdmanuals.com/professional/pediatrics/congenital-gastrointestinal-anomalies/duodenal-obstruction
  5. Ernst NP. A case of congenital atresia of the duodenum treated successfully by operation. Br Med J. 1916 May 6;1(2888):644-45. doi: 10.1136/bmj.1.2888.644
  6. Kimura K, Tsugawa C, Ogawa K, Matsumoto Y, Yamamoto T, Asada S. Diamond-shaped anastomosis for congenital duodenal obstruction. Arch Surg. 1977 Oct;112(10):1262-63. doi: 10.1001/archsurg.1977.01370100116026.
  7. Kozlov Y, Novogilov V, Yurkov P, Podkamenev A, Weber I, Sirkin N. Keyhole approach for repair of congenital duodenal obstruction. Eur. J. Pediatr. Surg. 2011; 21(2):124-127. doi: 10.1055/s-0030-1268455.
  8. Bax NM, Ure BM, van der Zee DC, van Tuijl I. Laparoscopic duodenoduodenostomy for duodenal atresia. Surg Endosc. 2001 Feb;15(2):217. doi: 10.1007/BF03036283.
  9. Chung PH, Wong CW, Ip DK, Tam PK, Wong KK. Is laparoscopic surgery better than open surgery for the repair of congenital duodenal obstruction? A review of the current evidences. J Pediatr Surg. 2017 Mar;52(3):498-503. doi: 10.1016/j.jpedsurg.2016.08.010.
  10. Li B, Chen WB, Wang SQ, Wang YB. Laparoscopic diagnosis and treatment of neonates with duodenal obstruction associated with an annular pancreas: report of 11 cases. Surg Today. 2015 Jan;45(1):17-21. doi: 10.1007/s00595-014-0850-3.
  11. Zelinskaya DI, Terletskaya RN. Regional peculiarities of infant mortality due to congenital defects in the Russian Federation. Det Bol’nitsa. 2013;(1):10-13. (in Russ.)
Address for correspondence:
625023, The Russian Federation,
Tyumen, Odesskaya Str., 54,
Tyumen State Medical University,
Department of Pediatric Surgery,
Tel. office: 8 (3452) 28-71-66,
e-mail: oria@yandex.ru,
Emelyanova Viktoria A.
Information about the authors:
Akselrov Mikhail A., MD, Associate Professor, Head of the Department of Pediatric Surgery, Tyumen State Medical University, Head of the Pediatric Surgery Unit ¹ 1, Regional Clinical Hospital ¹ 2, Tyumen, Russian Federation.
http://orcid.org/0000-0001-6814-8894
Emelyanova Viktoria A, Anesthesiologist-Resuscitator of the Department of Anesthesiology, Resuscitation and Intensive Care for Newborns and Premature Babies, Regional Clinical Hospital ¹ 2, Tyumen, Russian Federation.
http://orcid.org/0000-0002-9857-9174
Suprunec Svetlana N., PhD, Associate Professor of the Children’s Diseases Department of the Department, Tyumen State Medical University, Head of the Department of Anesthesiology, Resuscitation and Intensive Care for Newborns and Premature Babies, Regional Clinical Hospital ¹ 2, Tyumen, Russian Federation.
http://orcid.org/0000-0001-8579-1857
Sergienko Tatyana V., Pediatric Surgeon of the Pediatric Surgery Unit ¹ 1, Regional Clinical Hospital ¹ 2, Tyumen, Russian Federation.
http://orcid.org/0000-0003-3338-1260
Anoxina Irina G., Anesthesiologist-Resuscitator of the Department of Anesthesiology, Resuscitation and Intensive Care for Newborns and Premature Babies, Regional Clinical Hospital ¹ 2, Tyumen, Russian Federation.
http://orcid.org/0000-0002-7659-2458
Kiseleva Natalya V., Anesthesiologist-Resuscitator of the Department of Anesthesiology, Resuscitation and Intensive Care for Newborns and Premature Babies, Regional Clinical Hospital ¹ 2, Tyumen, Russian Federation.
http://orcid.org/0000-0003-3310-3826
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