Experience in treating gastrointestinal tract perforations in newborns in the Republic of Uzbekistan



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Abstract

Introduction. Despite of the fact that necrotic enterocolitis (NEC) is a common surgical disease in newborns, a significant breakthrough in its treatment has not been made yet.

Purpose. To analyze outcomes of surgical treatment at the NEC surgical stage in newborns.

Material and methods. Outcomes after surgical treatment of 71 newborns with necrotic enterocolitis at its surgical stage, who were admitted to the hospital in 2015-2020, have been analyzed.

Results and discussion. Diagnostic laparoscopy (DL) was prescribed if the surgical stage of the disease was not complicated with pneumoperitonitis. 37 patients had DL; of them 11 (29.7%) had conversion to laparotomy. In 26 (70.3%) patients, diagnostic laparoscopy was ended with therapeutic laparoscopy and video-assisted mini-laparotomy; among them there were 7 (26.9%) patients in whom gastric perforation was sutured. Resection of the necrotic part of the intestine with followed end-to-end anastomosis was made in 8 (30.7%) patients; in 11 (42.3%) patients, an intestinal stoma was created. In 45 newborns with the NEC surgical stage, surgeons chose the traditional surgical tactics. 34 (75.5%) patients with diagnosed pneumoperitoneum had laparocentesis to achieve decompression; 8 (17.7%) patients out of them died. 37 (82.2%) patients had laparotomy; in 5 (11.1%) out of them stomach perforations were sutured. In 32 (71.1%) patients, intestinal stomas were created. If to compare the obtained results after video-assisted laparoscopic surgeries, the mortality rate was as follows: 6 (23.1%) patients after laparoscopic interventions and 64.4% after traditional ones.

Conclusion. Diagnostic laparoscopy at the surgical stage of necrotizing enterocolitis allows to select tactics for radical surgical treatment, to transfer surgical treatment into non-surgical one, thus minimizing surgical trauma what impacts positively the postoperative survival of patients.

About the authors

Sh. T. Salimov

Tashkent Medical Academy

Email: fake@neicon.ru

Tashkent, 100109, Republic of Uzbekistan

Uzbekistan

B. Z. Abdusamatov

Republican Scientific and Practical Center of Little-invasive and Endovisual Surgery in Children

Author for correspondence.
Email: endocentr.uz@mail.ru
ORCID iD: 0000-0002-4830-7453

Z. Abdusamatov, MD, Dr.Sc.(med), Director

Tashkent, 100109, Republic of Uzbekistan

Uzbekistan

A. Sh. Vakhidov

Republican Scientific and Practical Center of Little-invasive and Endovisual Surgery in Children

Email: fake@neicon.ru

Tashkent, 100109, Republic of Uzbekistan

Uzbekistan

K. M. Umarov

Tashkent Medical Academy

Email: fake@neicon.ru

Tashkent, 100109, Republic of Uzbekistan

Uzbekistan

E. A. Berdiev

Republican Scientific and Practical Center of Little-invasive and Endovisual Surgery in Children

Email: fake@neicon.ru
ORCID iD: 0000-0002-3244-6619

Tashkent, 100109, Republic of Uzbekistan

Uzbekistan

Sh. Kh. Elmuradov

Republican Scientific and Practical Center of Little-invasive and Endovisual Surgery in Children

Email: fake@neicon.ru

Tashkent, 100109, Republic of Uzbekistan

Uzbekistan

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