rospedРоссийский педиатрический журнал имени М.Я. СтуденикинаM.Ya. Studenikin Russian Pediatric JournalФГАУ «НМИЦ здоровья детей» Минздрава России10.46563/1560-9561-2024-27-1-61-65qnfnsyrosped-535Research ArticleОБЗОРЫREVIEWSГастрошизис: диагностика и хирургическое лечениеGastroschisis: diagnosis and surgical treatmenthttps://orcid.org/0009-0009-9397-4384ПилоянФеликс СамсоновичPiloyanFelix S.

Клинический ординатор 2-го года обучения по специальности «детская хирургия» ФГАУ «НМИЦ здоровья детей» Минздрава России

e-mail: fpiloyan@bk.ru

National Medical Research Center for Children’s Health, Lomonosovskiy Prospect, 2/1, Moscow, 119991, Russian Federation

e-mail: fpiloyan@bk.ru

fpiloyan@bk.ruФГАУ «Национальный медицинский исследовательский центр здоровья детей» Минздрава РоссииNational Medical Research Center for Children’s Health2024040420242716165Copyright © Пилоян Ф.С., 20242024Пилоян Ф.С.Piloyan F.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rosped.ru/jour/article/view/535

Гастрошизис — это врождённый порок развития передней брюшной стенки новорождённого с дефектом преимущественно справа от нормально сформированной пуповины и эвентрацией органов брюшной полости. Эвентрированные внутренние органы не покрыты амниотическими оболочками. Несмотря на увеличение частоты этого порока с 3,6 до 4,9 на 10 тыс. живорождённых, за последние 10 лет летальность резко сократилась и составляет около 5%. Антенатальная диагностика позволяет достоверно выявить гастрошизис начиная с 12-й недели гестации, что имеет важное значение, особенно при диагностике осложнённых форм. Хирургическая коррекция порока предполагает первичную радикальную пластику передней брюшной стенки с одномоментным погружением эвентрированных органов в брюшную полость. Однако примерно у каждого 5-го пациента одномоментная коррекция невозможна из-за имеющейся висцероабдоминальной диспропорции и сопутствующих осложнений. В этих случаях применяют создание временной брюшной полости с отсроченной пластикой передней брюшной стенки, энтеростомией для декомпрессии кишечника, резекцией нежизнеспособных участков и наложением межкишечных анастомозов. Среди пациентов с осложнёнными формами порока летальность увеличена в 8 раз. В связи с этим продолжаются разработки различных методов лечения, направленные на выбор оптимального способа коррекции этого порока.

Финансирование

Финансирование. Исследование не имело спонсорской поддержки.

Конфликт интересов

Конфликт интересов. Автор заявляет об отсутствии конфликта интересов.

Поступила 18

Поступила 18.12.2023Принята к печати 30.01.2024Опубликована 28.02.2024

 

 

Gastroschisis is a congenital malformation of the anterior abdominal wall with a defect to the right of the normally formed umbilical cord and eventration of the abdominal organs. Evented internal organs not covered with amniotic membrane are under the direct influence of amniotic fluid. Despite the increase in the incidence of the defect from 3.6 to 4.9 per 10,000 live births, over the past ten years mortality has sharply decreased to 5%. Antenatal diagnosis makes it possible to reliably identify cases of gastroschisis, starting from the 12th week of gestation, which is important especially when diagnosing complicated forms. Surgical correction involves primary radical plastic surgery of the anterior abdominal wall with simultaneous immersion of the eventrated organs into the abdominal cavity. However, in approximately every fifth patient, immediate correction is impossible due to the occurrence of viscero-abdominal disproportion and concomitant diseases. In these cases, temporary abdominal cavity occurs with delayed plasty of the anterior abdominal wall, enterostomy for intestinal decompression, resection of non-viable areas and interintestinal anastomoses. Among patients with complicated forms, there was an 8-fold increase in mortality. Despite significant advances in reducing mortality, the development of various treatment methods continues to provide an alternative method of correcting this lesion.

Acknowledgment

Acknowledgment. The study had no sponsorship.

Conflict of interest

Conflict of interest. The author declares no conflict of interest.

Received

Received: December 18, 2023Accepted: January 30, 2024Published: February 28, 2024

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The authors declare that there are no conflicts of interest present.