MODERN APPROACHES TO DIAGNOSIS AND TREATMENT OF MEDIASTINUM NEOPLASMS IN CHILDREN

Aim. To assess modern possibilities for diagnosis and treatment of mediastinum neoplasms in children. Materials and methods. During the period of 1998-2013, seventy children with volume mediastinum neoplasms underwent treatment at the clinic of children’s surgery. Two groups of patients were formed depending on the technique of operative intervention: 39 patients were operated with thoracoscopy (main group); 31 patients underwent an open surgery (control group). Children’s age was from some months to 14 years. Diagnostic techniques included: ultrasound (US), multiple view roentgenological investigation, computer tomography (CT), magnetic-resonance tomography (MRT), laboratory tests. When conducting comparative assessment of surgical techniques, the following parameters were taken into consideration: operation duration, hemorrhage, terms of artificial pulmonary ventilation, need and duration of staying at resuscitation unit, character and duration of postoperative anesthesia, complications. Results. In the structure of children’s mediastinum neoplasms, there prevail neurogenic tumors (40 %) and archenteron tumors (24,3 %). Use of US, CT, MRT significantly widens the notion of topography of volume processes in the mediastinum, the correlation between the neoplasm and the surrounding organs and tissues. Comparative analysis of the results of treatment of children operated with open and endosurgical techniques showed the advantage of thoracoscopy. Conclusions. It is necessary to use differentiated approach to treatment of children with mediastinum tumors taking into account the age, sizes and character of neoplasms.

Mediastinum tumors, children, surgery