Long-term results of treatment of newborns and infants with necrosis and perforation of the stomach and duodenum

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Abstract

INTRODUCTION: Necrosis and perforation of the stomach and /or duodenum in newborns and infants is a rare but severe disease with high mortality. There are many theories about the etiology and pathogenesis of the necrosis and perforation of the stomach and duodenum in children of this age. Various treatment options are described, but neither foreign nor Russian publications have assessed the long-term results of the treatment of patients with perforation of the stomach and duodenum during the first year of life and the quality of their life.

AIM: This study aimed to analyze the results of treatment of newborns and infants with perforation of the stomach and duodenum and to assess their long-term quality of life.

MATERIALS AND METHODS: The study analyzes the long-term results of treatment of 21 children, aged 2–12 yrs, with perforation of the stomach and duodenum. The volumetric evacuation function of the stomach and duodenum and the child’s nutritional status were assessed. A survey of patients and their parents was also carried out to assess the quality of life of the child using questionnaires from the EuroQol Research Foundation version EQ5D-Y.

RESULTS: The volumetric evacuation function of the stomach and duodenum recovered completely. The nutritional status of 16 (76%) children corresponds to their age. According to the results of the analysis of the questionnaire of the quality of life, eight patients aged >8 yrs and 15 parents consider the health profile of children as the best (71%), the parents of one patient assess the health profile of their child as satisfactory, and five mothers of children with neurological deficits rated as unsatisfactory.

CONCLUSION: Owing to the high adaptation capacity of the newborn and infants of the first year of life, most of the examined patients have a good quality of life and a normal nutritional status. The volumetric evacuation function of the stomach and duodenum recovered in all patients within 1–3 yrs after surgery.

About the authors

Anastasiia A. Skopetc

I.I. Mechnikov North-Western State Medical University; Children’s city multidisciplinary clinical specialized center for high medical technologies

Author for correspondence.
Email: anastasiya.sk@inbox.ru
ORCID iD: 0000-0001-8831-4693

pediatric surgeon, postgraduate student

Russian Federation, 14 Avangardnaya str., Saint Petersburg, 198205

Svetlana A. Karavaeva

I.I. Mechnikov North-Western State Medical University; Children’s city multidisciplinary clinical specialized center for high medical technologies

Email: svetlana.karavaeva@szgmu.ru
ORCID iD: 0000-0001-5884-9128
SPIN-code: 4224-5532

Dr. Sci. (Med.), Professor

Russian Federation, 14 Avangardnaya str., Saint Petersburg, 198205

Tatiana K. Nemilova

Children’s city multidisciplinary clinical specialized center for high medical technologies; Academican I.P. Pavlov First St. Petersburg State Medical University, Saint Petersburg

Email: nemilova@mail.ru
ORCID iD: 0000-0002-0922-0638
SPIN-code: 6961-6633

Dr. Sci. (Med.), Professor

Russian Federation, 14 Avangardnaya str., Saint Petersburg, 198205

References

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Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. 1. Patient health questionnaire for parents

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3. Fig. 2. Patient health questionnaire

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4. Fig. 3. Volumetric evacuation function of the stomach and duodenum

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5. Fig. 4. Gastrography in a 10-year-old child after extensive gastric necrosis (a diverticulum is marked with a circle): a — frontal view, b — lateral view

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6. Fig. 5. Scheme of the resection of necrotic tissue with the formation of a gastric “tube” from the intact stomach wall with a significant decrease in the volume of the organ

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7. Fig. 6. Scheme of gastrectomy with reconstruction according to Hunt–Lawrence

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8. Fig. 7. Gastrogram of a child: a — on the 10th day after extensive gastric resection, a formed gastric tube is visible; b — after 5 years in direct projections; c — lateral view, the shape, and volume of the stomach were restored

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