[Advantages of Kasai procedure through minimally invasive approach in children with biliary atresia (in Russian only)].

Autor: Razumovskiy AY; Pirogov Russian National Research Medical University, Moscow, Russia; Filatov Munitsipal Children's Hospital, Moscow, Russia., Degtyareva AV; Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of Ministry of Health of the Russia, Moscow, Russia; Sechenov First Moscow State Medical University of Ministry of Health of the Russia, Moscow, Russia., Kulikova NV; Filatov Munitsipal Children's Hospital, Moscow, Russia., Ratnikov SA; Pirogov Russian National Research Medical University, Moscow, Russia; Filatov Munitsipal Children's Hospital, Moscow, Russia.
Jazyk: ruština
Zdroj: Khirurgiia [Khirurgiia (Mosk)] 2019 (3), pp. 48-59.
DOI: 10.17116/hirurgia201903148
Abstrakt: Aim: To compare early and long-term results of different surgical interventions in children with biliary atresia.
Material and Methods: Retrospective analysis included medical records of children with biliary atresia who were treated at the Filatov Munitsipal Children's Hospital and National Medical Research Center for Obstetrics, Gynecology and Perinatology from 2000 to 2018. There were 91 patients. All patients were divided into three groups. Group 1 - conventional Kasai procedure (n=24), group 2 - laparoscopic Kasai surgery (n=45), group 3 - Kasai procedure through minimally invasive approach (n=22). Groups were comparable.
Results: Duration of Kasai procedure through minimally invasive approach was 69±12,97 min that was significantly less than in groups 1 and 2 (p 1,3 =0,006085; p 2,3 =0,000024). ICU-stay was minimal in group 3 (1.27±0.55 days, p 1,3 <0,05; p 2,3 <0,05). Abdominal drainage time was maximal in group 2 (11.28±6.37 days) and minimal in group 3 (5.86±2.39 days, p 2,3 =0.0002). Early and 2-year postoperative surgical efficiency was similar in all groups. There were no surgical complications in group 3. In group 2 one child had gastrointestinal bleeding followed by successful medication. There were 3 surgical complications in group 3: adhesive intestinal obstruction, small and large intestine perforation and 2 cases of gastrointestinal bleeding. There was one lethal outcome in the first group. Overall annual survival in children with native liver was 81.8%, 2-year - 51.7%.
Conclusion: Kasai procedure through minimally invasive approach is justified and rational method with certain benefits of open and laparoscopic interventions and can be considered as a method of choice in treatment of children with biliary atresia.
Databáze: MEDLINE
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