FIRST EXPERIENCE OF LAPAROSCOPIC DUODENO-DUODENAL ANASTOMOSIS IN NEONATES WITH HIGH INTESTINAL OBSTRUCTION CAUSED BY ANNULAR PANCREAS
In The Russian Federation, congenital malformations occupy the second place in the structure of infant mortality. Improving operational tactics, anesthesia and post-operative care is an important goal in reducing mortality from this group of diseases. Reduction of the traumatic nature of a surgical intervention directly correlates with the course of the postoperative period. The introduction of a minimally invasive, laparoscopic method of performing the operation must optimize the postoperative period. But volumetric laparoscopic interventions in newborns are difficult. Therefore, the description of laparoscopic treatment of the duodenal obstruction caused by the annular pancreas is sporadic. In the Children's Surgery Clinic of Tyumen State Medical University, 5 newborns with the duodenal obstruction, caused by the annular pancreas, were operated with the use of laparoscopic technique. The course of the disease in all children was typical. The congenital malformation of development was corrected by the laparoscopic formation of duodeno-duodenal anastomosis. The postoperative period was more uneventful in these children compared with those operated openly. The operation technique and the postoperative course did not differ significantly. Enteral nutrition was started within a week after the operation in all children. After laparotomy, the passage through the gastrointestinal tract is restored not earlier than 10, often 14 days. It is associated with quicker stopping of the inflammation in the anastomosis zone. The article describes in details one clinical case. The technique of laparoscopic duodeno-duodenal anastomosis, when a surgeon has the experience of working with newborns, is a safe, effective technique and can be a choice of surgical treatment of congenital duodenal obstruction caused by the annular pancreas.