Первичный врожденный стеноз трахеи у ребенка грудного возраста Республиканский научно-практический центр детской хирургии 1 , Минский научно-практический центр хирургии, трансплантологии и гематологии 2 , Республиканский научно-практический центр онкологии и медицинской радиологии имени Н.Н. Александрова 3 , Белорусский государственный медицинский университет 4 , г. Минск, Республика Беларусь

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Surgical Methods of Treatment of Giant Omphalocele in Children A.V. Zapalianski, O.V. Kandratsyeva, A.A. Svirsky в обзоре описаны различные варианты как классических, так и современных методов хирургической коррекции врожденного порока развития передней брюшной стенки-омфалоцеле больших размеров. приведены основные существующие методики, такие как первичная пластика, этапное и отсроченное закрытие дефекта. особое внимание уделено таким перспективным направлениям этапного хирургического лечения, как вакуум-ассистированное закрытие дефекта, использование тканевых экспандеров и систем наружного вытяжения. указаны достоинства и недостатки каждого метода, а также проведен сравнительный анализ их эффективности. приведены примеры новых хирургических методик коррекции порока, в основе которых лежат достижения современных биоинженерных исследований и инновационных технологий. рассмотрены перспективы применения биодеградабельных биоматериалов, таких как «аллодерм» и подслизистый слой тонкой кишки для пластики передней брюшной стенки и первичного закрытия дефекта. подробно описаны различные подходы к реконструктивному лечению больших дефектов передней брюшной стенки у детей старшего возраста после формирования вентральной грыжи в период новорожденности. проведен анализ опыта применения техники разделения слоев передней брюшной стенки для абдоминопластики в периоде новорожденности и более старшем возрасте, а также намечены пути улучшения косметических и физиологических результатов лечения. Ключевые слова: омфалоцеле больших размеров, новорожденный, дефект передней брюшной стенки, хирургическое лечение, этапное закрытие дефекта, отсроченное закрытие дефекта The review describes various options of classical and modern techniques of surgical treatment of congenital malformation of the anterior abdominal wall-the giant omphalocele. The main existing techniques are presented, such as primary, staged and delayed closure of the defect. Particular attention is paid to such perspective areas of the staged surgical treatment as vacuum-assisted closure, using of tissue expanders and systems with active external traction. The advantages and disadvantages of each technique are indicated and a comparative analysis of their effectiveness is carried out. Examples of new surgical options for correction of the malformation are presented, based on the achievements of modern bioengineering researches and innovative technologies. The prospects of the using the biodegradable biomaterials, such as «Alloderm» and submucosal layer of the small intestine for reconstruction of the abdominal wall and primary closure of the defect are analyzed. The review details various approaches of reconstructive surgical treatment of large abdominal wall defects in older children after the formation of ventral hernia in newborns. The application experience of the component separation technique (CST) for abdominoplasty in the period of newborns and older age is analyzed, and also the ways to improve the cosmetic and physiological results of the treatment are outlined.

Granular cell tumors were first described by Weber in 1854. But its muscular origin was suggested, studied in detail and differentiated by the pathologist A.I. Abrikosov in 1926. With the development of immunohistochemical analysis, a version of Abrikosov's tumor pathogenesis appeared, suggesting its origin from Schwann cells. The data obtained confirmed the presence of protein S-100, neuron-specific enolase (NSE) and CD68 in tumor cells. At present, when carrying out histochemical analysis, the expression of proteins S-100 and CD68 in tumor cells is a diagnostic criterion for Abrikosov's tumor. In treatment of granular cell tumors of the esophagus, preference is given to minimally invasive endoscopic techniques, since conservative therapy has proved to be ineffective. Considering that in most cases the tumor is benign in nature, recently many authors have recommended endoscopic resection of the mucous membrane and dissection in the submucosa. This article presents the experience of treating a child with a rare Abrikosov's tumor in the lower third of the esophagus using endoscopic technique. The clinical case described proved to be a difficult diagnostic task, since Abrikosov's tumor in the esophagus in a teenager is an extremely rare pathology with a rare localization. To remove the tumor, a non-standard endoscopic technique was chosen, which made it possible to remove the formation in a single block, that is, radically, since preoperative morphological verification was impossible. Much attention is focused on the importance of endoscopic examination in diagnostic screening and the choice of treatment tactics. This work demonstrates high efficiency and safety of endoscopic tumor removal in this localization. The use of this surgical treatment technique made it possible to radically remove the tumor and ensure a smooth course of the postoperative period. The research was carried out in accordance with the principles of the Helsinki declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: granular cell tumor, Abrikosov's tumor, tumor of the esophagus, esophagus, children, endoscopic treatment.