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Diagnosis and treatment of Hirschsprung's disease in newborns and infants


Author: Boian Veaceslav
Degree:doctor of medicine
Speciality: 14.00.35 - Infantine Surgery
Year:2018
Scientific advisers: Eva Gudumac
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova

,
Institution: Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova

Status

The thesis was presented on the 13 July, 2018 at the meeting of the Scientific Council and now it is under consideration of the National Council.

Abstract

Adobe PDF document1.28 Mb / in romanian

Thesis

CZU 616.348-007.61-053.3-07-089(043.2)

Adobe PDF document 5.88 Mb / in romanian
146 pages


Keywords

Hirschsprung's disease, newborns, infants, diagnosis, treatment

Summary

The research area: pediatric surgery

Study aim: Optimization of tactics of diagnosis and treatment of Hirschsprung's disease in newborns and infants, aimed at preventing complications and improving the results of surgical treatment.

Study objectives:Identify the clinical and paraclinical features of Hirschsprung's disease in neonates and infants and the development of individually adapted algorithm for the diagnosis and surgical treatment. Justification optimal preoperative preparation and surgical correction, depending on the anatomic and topographic and clinical features of the disease. Assessment of the effectiveness of treatment results directly after the operation and at a distance.

The novelty and the scientific originality: There have been developed and implemented: an algorithm for the diagnosis of Hirschsprung's disease in newborns and infants; combined method of preoperative preparation of the colon using intubation, repeated-dose washing one percent solution of NaCl, and local irrigation medication Enterosgel and Eubiotic baby, aimed at correcting and maintaining intestinal biocenosis.

The scientific solved problem:To determine the clinical and laboratory features of the development of Hirschsprung's disease in newborns and infants. The estimation of informativeness of different methods of research in the development of therapeutic and diagnostic algorithm of the disease.

The theoretical significance: The clinical significance of immunohistochemical tests for neuron specific enolase (NSE), neurofilament protein (NFP), synaptophysin (SYP) and chromogranin (CGA), to assess the degree of neuronal damage in the extended segment of the colon. Clinically proven preoperative preparation of the colon by intubation and dosed repeated washing with one percent solution of NaCl, Enterosgel and local irrigation Eubiotic baby preparations.

The applicative value of the work: Detailed clinical and laboratory features of the development of Hirschsprung's disease in newborns and infants, their dependence on the location and extent of aganglionar areas were represented, premorbid background and comorbidities. Based on the survey was developed and implemented a diagnostic and treatment algorithm for Hirschsprung's disease in newborns and infants.

The implementation of scientific results:On the basis of this study, new methods of diagnosis and treatment of newborns and infants were implemented with Hirschsprung's disease in three surgical departments of the Institute of Mother and Child in the educational process at the Department of Pediatric Surgery SUMPh “Nicolae Testemitanu”