DIAGNOSIS AND RESULTS OF SURGICAL TREATMENT OF CONGENITAL DUODENAL OBSTRUCTION IN NEWBORNS

Аннотация

The first experience with laparoscopic correction of duodenal obstruction in newborns was presented in 2001, but there is still debate about the preferred method of surgical correction. The article presents the experience of introducing laparoscopic technology for applying duodeno-duodenoanastomosis at the Republican Training, Treatment and Methodological Center for Neonatal Surgery at the RPC. During the period 2017-2023, 134 newborns with duodenal obstruction were treated. Antenatally, the defect was detected in 74 (55.2%) cases; these children were born in a specialized maternity hospital. Postnatal verification of the diagnosis was carried out using plain radiography of the abdominal cavity, but in doubtful cases, contrast fluoroscopy was performed. Open correction of the defect was performed in 82 (62.1%) patients, laparoscopic - 39 (29.5%), laparoscopy/conversion - 11 (8.4%). In the postoperative period, various complications were observed in 34 (25.7%) patients. Anastomotic failure occurred in 8 (6%) patients. Mortality was 20.4%, but it was mainly due to severe concomitant pathology. Thus, although patients with congenital duodenal obstruction were treated laparoscopically, the duration of the operation was longer than with the traditional method. The length of hospital treatment was reduced to 1.6 days, narcotic anesthesia was reduced to 24 hours, and the cosmetic effect was high.