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Introduction. Currently, the day-care hospital service is being developed because of the need to improve medical, social and economic efficiency of medical institutions, and by a high demand in this type of medical care. However, there are only few publications on hospital-substituting technologies in pediatric surgery in the domestic literature. In addition, the problem of laparoscopic surgeries in children in a short stay hospital unit is still a controversial issue. Purpose. To evaluate the effectiveness of a short stay surgical department as a structural unit in a multidisciplinary pediatric hospital. Material and methods. The researchers have analyzed the effectiveness of a short-stay hospital surgical unit in the Morozov Children’s Clinical Hospital. The pediatric short stay surgical unit, being a structural subdivision of a multidisciplinary hospital, provides medical care for children in the following profiles: “Pediatric surgery”, “Pediatric urology and andrology”, “Traumatology and orthopedics”, “Ophthalmology”, “Otorhinolaryngology”, “Maxillofacial surgery” and “Gynecology”. Results. From February 2017 till May 2019, 7128 surgical interventions were performed in this unit; 1371 of them were laparoscopic ones for inguinal hernias, varicocele, non-palpable testicular syndrome. In the hospital, a unique anesthetic algorithm for laparoscopic surgeries with a double luminal laryngeal mask and without muscular relaxants and narcotic analgesics was developed. The length of stay of patients in this unit is 6-8 hours, in the average. During the abovementioned 3-year period, only one patient was transferred to a 24-hour hospital. There were no surgical complications. Conclusion. The short-stay surgical unit in the Morozov Children’s Clinical Hospital has radically improved the availability of medical care for children; in addition, more surgical beds for hi-tech medical care are free and available now. Laparoscopic surgeries can be performed in this unit, instead of being performed in the round-clock surgical departments, due to the algorithm of safe anesthesia for planned surgical interventions which had been developed in the short-stay hospital surgical unit.

The present multi-center non-randomized open prospective phase IV study was carried out based at 8 clinical centers of the Russian Federation. It included 89 patients at the age from 6 to 17 years suffering from type 1 diabetes mellitus during a period over 1 year. The children treated with Lantus (insulin glargin) in combination with any short-acting insulin in accordance with the basal-bolus regime and having the HbA1c level from=>8% to =<10% were transferred to Apidra (insulin glulisine) therapy in combination with Lantus insulin. The number of patients in the first age group (6-12 years) having the HbA1c level <8% within 12 months after the onset of therapy was 51.1%. However, only 31.1% of them, did not experience episodes of symptomatic hypoglycemia during this period with the blood glucose level =< 3.1 mmol/l. In the age group 2 (13-17 years), 31.1% of the patients reached the target HbA1c level <7.5% during the 12 month treatment period, but only 13.3% had no episodes of symptomatic hypoglycemia of =<3.1 mmol/l during this period. The HbA1c level in groups 1 and 2 decreased from 8.75±0.6 to 8.05 ±1.06% (p=0.046658) and from 8.77±0.58 to 7.96±1.12% (p=0.017533) respectively. The requirements for insulin in either group did not significantly change throughout the study period. A total of 1866 hypoglycemic episodes were recorded (i.e. 20.73 episodes per patient) including 90.8% of daytime and 9.2% of nocturnal hypoglycemia; symptomatic hypoglycemia accounted for 98.8% of all the cases and asymptomatic one for 1.2%. Fifty three (0.35%) cases were interpreted as severe hypoglycemia (blood glucose level ≤2 mmol/l), five (0.27%) patients had to be hospitalized . Hypoglycemic episodes were not documented in 13 children.