Intestinal anastomoses in children: The draft decision of the Russian Symposium of Children surgeons (April 2023)
- Authors: Akselrov M.A.1, Dyakonova E.Y.2, Karavaeva S.A.3, Karaseva O.V.4, Kovarskiy S.L.5, Kozlov Y.A.6, Minaev S.V.7, Mokrushina O.G.5, Morozov D.A.8, Petlakh V.I.8, Poddoubny I.V.9, Podkamenev A.V.10, Razumovskiy A.Y.5, Sokolov Y.Y.11, Kholostova V.V.5, Tsap N.A.12
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Affiliations:
- Tyumen State Medical University
- National Medical Research Center for Children’s Health
- North-Western State Medical University named after I.I. Mechnikov
- Clinical and Research Institute of Emergency Pediatric Surgery and Trauma
- N.I. Pirogov Russian National Research University
- Irkutsk State Medical Academy of Postgraduate Education
- Stavropol State Medical University
- Yu.E. Veltishchev Research Clinical Institute of Pediatrics and Pediatric Surgery, N.I. Pirogov Russian National Research University
- A.I. Evdokimov Moscow State University of Medicine and Dentistry
- Saint Petersburg State Pediatric Medical University
- Russian Medical Academy of Continuous Professional Education
- Ural State Medical University
- Issue: Vol 13, No 2 (2023)
- Pages: 271-279
- Section: Clinical Practice Guidelines
- URL: https://journals.rcsi.science/2219-4061/article/view/132781
- DOI: https://doi.org/10.17816/psaic1526
- ID: 132781
Cite item
Abstract
The Symposium of Pediatric Surgeons of Russia, “Intestinal Anastomoses in Children,” was conducted in Volgograd on April 26, 2023, with around 180 doctors in attendance. Thirty papers were presented and discussed, and 41 articles were published in the proceedings of the symposium. According to the results of a systemic analysis of a questionnaire poll of major pediatric surgeons in 75 regions of Russia, 4,558 surgeries on intestinal anastomosis formation were performed in 2021–2022, including 1,735 operations in newborn children (36%); their share in general pediatric surgery was less than 0.6%, and it was more than 18.6% in neonatal surgeons. The number of intestinal anastomoses formed during laparoscopic procedures increased (4.4%). Pediatric surgeons equally often used double-row nodal intestinal sutures (33.3%), single-row continuous sutures (34.6%), and different types of sutures (33.3%). A T-shaped anastomosis was performed in cases of necrotizing enterocolitis where there was a significant difference in the diameters of the intestine's inflow and outflow channels. The clip-and-drop technique was used to treat neonates with multifocal necroses. Interintestinal anastomoses were favored over enterostomies in numerous segmental resections. For duodenal obstruction, duodeno-duodenal, and duodeno-jejunal anastomoses were performed. In children with Crohn's disease and choledochal cysts, most specialists prefer operations with stapling devices. Creating a magnetic interintestinal anastomosis lowers the risk of postoperative complications and facilitates the postoperative period. Clinical observations after laparoscopic surgeries accounted for a significant proportion of complications (66%). Anastomosis failure was three times more common in planned small intestinal in older children than in emergency surgeries (1.2 and 0.4%, respectively).
The modern stage of development of intestinal anastomosis formation techniques in children is characterized by good results, the expansion of indications for intestinal anastomosis in conditions of compromised colon or peritonitis, and the introduction of laparoscopic techniques and mechanical stapling devices with slightly poorer results.
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##article.viewOnOriginalSite##About the authors
Mikhail A. Akselrov
Tyumen State Medical University
Email: akselerov@mail.ru
ORCID iD: 0000-0001-6814-8894
SPIN-code: 3127-9804
Dr. Sci. (Med.), Professor
Russian Federation, TyumenElena Yu. Dyakonova
National Medical Research Center for Children’s Health
Email: dyakonova@nczd.ru
ORCID iD: 0000-0002-8563-6002
SPIN-code: 5709-3352
Dr. Sci. (Med.)
Russian Federation, MoscowSvetlana A. Karavaeva
North-Western State Medical University named after I.I. Mechnikov
Email: swetl.karavaewa2015@yandex.ru
ORCID iD: 0000-0001-5884-9128
SPIN-code: 4224-5532
Dr. Sci. (Med.), Professor
Russian Federation, Saint PetersburgOlga V. Karaseva
Clinical and Research Institute of Emergency Pediatric Surgery and Trauma
Email: karaseva.o@list.ru
ORCID iD: 0000-0001-9418-4418
SPIN-code: 7894-8369
Dr. Sci. (Med.), Professor
Russian Federation, MoscowSemen L. Kovarskiy
N.I. Pirogov Russian National Research University
Email: sim3150@gmail.com
ORCID iD: 0000-0001-6310-7110
SPIN-code: 9308-5014
Dr. Sci. (Med.), Professor
Russian Federation, MoscowYuri A. Kozlov
Irkutsk State Medical Academy of Postgraduate Education
Email: yuriherz@hotmail.com
ORCID iD: 0000-0003-2313-897X
SPIN-code: 3682-0832
Dr. Sci. (Med.), Professor, Member of the Russian Academy of Sciences
Russian Federation, IrkutskSergey V. Minaev
Stavropol State Medical University
Email: sminaev@yandex.ru
ORCID iD: 0000-0002-8405-6022
SPIN-code: 3113-6982
Dr. Sci. (Med.), Professor
Russian Federation, StavropolOlga G. Mokrushina
N.I. Pirogov Russian National Research University
Email: mokrushina@yandex.ru
ORCID iD: 0000-0003-4444-6103
SPIN-code: 5998-7470
Dr. Sci. (Med.), Professor
Russian Federation, MoscowDmitry A. Morozov
Yu.E. Veltishchev Research Clinical Institute of Pediatrics and Pediatric Surgery, N.I. Pirogov Russian National Research University
Email: damorozov@list.ru
ORCID iD: 0000-0002-1940-1395
SPIN-code: 8779-8960
MD, Dr. Sci. (Med.), Professor
Russian Federation, MoscowVladimir I. Petlakh
Yu.E. Veltishchev Research Clinical Institute of Pediatrics and Pediatric Surgery, N.I. Pirogov Russian National Research University
Email: vladimirip1@gmail.com
ORCID iD: 0000-0001-5403-313X
SPIN-code: 9100-6976
https://pedklin.ru/specialisty/petlakh-vladimir-ilich/
Dr. Sci. (Med.), chief researcher
Russian Federation, MoscowIgor V. Poddoubny
A.I. Evdokimov Moscow State University of Medicine and Dentistry
Email: igorpoddoubnyi@yandex.ru
ORCID iD: 0000-0002-9077-6990
SPIN-code: 4340-8700
Dr. Sci. (Med.), Professor
Russian Federation, MoscowAlexey V. Podkamenev
Saint Petersburg State Pediatric Medical University
Email: podkamenev@hotmail.com
ORCID iD: 0000-0001-6006-9112
SPIN-code: 7052-0205
Dr. Sci. (Med.), assistant professor
Russian Federation, Saint PetersburgAlexandr Yu. Razumovskiy
N.I. Pirogov Russian National Research University
Email: 1595105@mail.ru
ORCID iD: 0000-0003-3511-0456
SPIN-code: 3600-4701
Dr. Sci. (Med.), Professor, Member of the Russian Academy of Sciences
Russian Federation, MoscowYury Yu. Sokolov
Russian Medical Academy of Continuous Professional Education
Email: sokolov-surg@yandex.ru
ORCID iD: 0000-0003-3831-768X
SPIN-code: 9674-1049
Dr. Sci. (Med.), Professor
Russian Federation, MoscowValeriya V. Kholostova
N.I. Pirogov Russian National Research University
Email: vkholostova@yandex.ru
ORCID iD: 0000-0002-3463-9799
SPIN-code: 7923-6493
Dr. Sci. (Med.), assistant professor
Russian Federation, MoscowNatalya A. Tsap
Ural State Medical University
Author for correspondence.
Email: tsapna-ekat@rambler.ru
ORCID iD: 0000-0001-9050-3629
SPIN-code: 7466-8731
Dr. Sci. (Med.), Professor
Russian Federation, YekaterinburgReferences
- Collection of materials of the Russian educational symposium of pediatric surgeons “Intestinal anastomoses” (Volgograd, 2023 April 26) and the 29th All-Russian (62nd “All-Union”) scientific student conference “Actual issues of surgery, anesthesiology and resuscitation of children age” (Volgograd, 2023 April 27–29), dedicated to the 80th anniversary of the Victory in Stalingrad-battle and the 50th anniversary of the organization of the Department of Pediatric Surgery of the Volgograd State Medical University. Ed. by M.E. Statsenko, A.I. Perepelkina. Volgograd: VolgGMU, 2023. P. 6–79. (In Russ.) Available from: https://conf2023.radh.ru/Volgograd_2023_print.pdf
