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SURGICAL TREATMENT OF FOCAL FORMS OF CONGENITAL HYPERINSULINISM: IS ALL CLEAR?
- Authors: Sukhotskaya A.A.1, Bairov V.G.1, Nikitina I.L.1, Ryzhkova D.V.1, Mitrofanova L.B.1, Amidkhonova S.A.1
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Affiliations:
- V.A. Almazov National Medical Research Centre, Institute of Perinatology and Pediatrics, Institute of Surgery for Congenital and Hereditary Pathologies, Surgical Department of Developmental Malformations
- Issue: Vol 23, No 6 (2019)
- Pages: 296-302
- Section: ORIGINAL ARTICLES
- URL: https://jps-nmp.ru/jour/article/view/179
- DOI: https://doi.org/10.18821/1560-9510-2019-23-6-296-302
- ID: 179
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Abstract
Introduction. 30-60% of all patients with congenital hyperinsulinism have a delayed psychomotor development, and 15-25% of them have severe organic brain damage, including epilepsy. Timely diagnostics and intensive treatment can prevent severe neurological complications. With the ineffectiveness of conservative therapy, surgical treatment is a necessary alternative. Objective. To define indications for various options of surgical correction of focal forms of congenital hyperinsulinism. Material and Methods. In the Department of Pediatric Surgery of V.A. Almazova National Medical Research Centre, in 2017-03.2019, 14 children with focal forms of congenital hyperinsulinism were operated after analyzing their PET-CT findings; in 2 patients out of them they were doubtful. Results. 13 (93%) patients had a complete relief of hyperinsulinism and a significant improvement in their psycho-motor development. 10 (71%) of 14 children had a complete recovery; 1 (7%) - a significant positive trend. 3 (21%) patients needed insulin therapy with minimal dosages. They all were children with an atypical (mixed adenomatous-diffuse) form of hyperinsulinism. Conclusions. In case of focal lesions in the pancreas, partial pancreatectomy with maximal preservation of healthy tissue, defined by the express biopsy, and with any lesion localization is indicated. For atypical forms, the volume for pancreatectomy dissection is defined individually.
About the authors
A. A. Sukhotskaya
V.A. Almazov National Medical Research Centre, Institute of Perinatology and Pediatrics, Institute of Surgery for Congenital and Hereditary Pathologies, Surgical Department of Developmental Malformations
Author for correspondence.
Email: sukhotskaya_aa@almazovcentre.ru
ORCID iD: 0000-0002-8734-2227
Russian Federation
V. G. Bairov
V.A. Almazov National Medical Research Centre, Institute of Perinatology and Pediatrics, Institute of Surgery for Congenital and Hereditary Pathologies, Surgical Department of Developmental Malformations
Email: noemail@neicon.ru
Russian Federation
I. L. Nikitina
V.A. Almazov National Medical Research Centre, Institute of Perinatology and Pediatrics, Institute of Surgery for Congenital and Hereditary Pathologies, Surgical Department of Developmental Malformations
Email: noemail@neicon.ru
Russian Federation
D. V. Ryzhkova
V.A. Almazov National Medical Research Centre, Institute of Perinatology and Pediatrics, Institute of Surgery for Congenital and Hereditary Pathologies, Surgical Department of Developmental Malformations
Email: noemail@neicon.ru
Russian Federation
L. B. Mitrofanova
V.A. Almazov National Medical Research Centre, Institute of Perinatology and Pediatrics, Institute of Surgery for Congenital and Hereditary Pathologies, Surgical Department of Developmental Malformations
Email: noemail@neicon.ru
Russian Federation
S. A. Amidkhonova
V.A. Almazov National Medical Research Centre, Institute of Perinatology and Pediatrics, Institute of Surgery for Congenital and Hereditary Pathologies, Surgical Department of Developmental Malformations
Email: noemail@neicon.ru
Russian Federation
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