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The efficacy of preparation "Tachocomb" application in 224 children, ageing from 1 day to 18 years old, was studied up. The spectrum of the preparation studying had included the investigation of its properties, which secure an additional isolation for the intestinal and vascular walls defects, and hemostatic effect in the hemorrhage area as well. The data obtained trust the safety and efficacy of "Tachocomb" platelets application in pediatric surgery and permit to recommend them for improvement of the surgical treatment results.

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As many as fourteen children with teratodermoid tumours of the mediastinum were examined and treated at the department of surgery of developmental abnormalities of the Institute of Pediatrics, Obstetrics and Gynecology. Intrathoracal compression of the respiratory tracts caused by a ripe teratodermoid tumour was identified in 7 patients, by an unripe tumour--teratoblastoma--in one patient. Some specificities of intrathoracal compression of the respiratory tracts have been studied together with complications thereof.

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Twelve children with mediastinal teratodermoid tumor, causing intrathoracic compression of respiratory ways (ITCRW) in 8 of them, were treated in clinic. In 75% of children with ITCRW the conduction of special preoperative preparation was necessary. All the patients were operated on. Tumor was removed en bloc or using the fragmentation method. In secondary tracheomalacia the anterior aortopexy for the tracheal lumen preservation was done simultaneously.

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In the clinic there were operated on 8 patients with bronchogenic and enterogenic mediastinal cyst, complicated by intrathoracic compression of respiratory ways. In 2 children postoperative complications occurred. In presence of secondary tracheomalacia, caused by tracheal compression by bronchogenic cyst, aortopexy was done in conjunction with the cystic formation excision. All the patients survived. In 6 children satisfactory result was noted, in 2--relatively satisfactory one.

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Overall, twenty-eight children with intrathoracic airway compressions (IAC) caused by double aortic arch (DAA), who ranged 1.5 months to eleven years old, were kept under medical surveillance. The following respiratory symptoms were found to dominate the clinical picture in the above pediatric patient population: stridor, dyspnea, bouts of asphyxia, orthopnea, with secondary bronchopulmonary complications having been disclosed in all. The diagnosis of IAC and its complications in DAA was based on findings from thoracic roentgenography, esophagography, digital subtraction angiography, and tracheobronchoscopy. This pathology surgical correction indications were unquestionable. The policy has been worked out of treating DAA-associated IAK through surgery, with particular regard to the anatomical variants of the defect under question and its complications.

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In 1982-1999 period 49 children aged 1.5 mo-14 yrs with vascular ring anomaly were examined. In 28 of them the double aortal arch (DAA), causing intrathoracic compression of respiratory ways, was revealed. Surgical correction of DAA was done in 27 patients. Optimal surgical access is left-sided lateral thoracotomy along third or fourth intercostal space. Tactics of surgical intervention was differentiated one depending on anatomo-topographic peculiarities of aortal arch morphology, its branches and age of a child. Aortopexy was done together with vascular failure correction for concomitance with secondary tracheomalacia and Kommerel's diverticulum.

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Examination and treatment of 16 children with vascular tumor of mediastinum ageing from 22 days to 11 years was conducted. In 12 patients the respiratory ways compression was noted. The mistakes and dangers while tumor excision were analysed, the methods of their prophylaxis using special technical tricks while performing the operation were elaborated.

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Over the period 1983-1999 examination was done together with a surgical treatment of ten children with bronchogenic (BG) and enterogenic (EG) cysts of the mediastinum, their ages ranging between 2 months to 13 years, having been kept under medical surveillance in the clinic for thoracoabdominal surgery of developmental anomalies in children. In 80 percent of patients intrathoracic compression of the respiratory tracts caused by the above cysts was diagnosed. 87.5 percent of patients had inflammatory bronchopulmonary problems, 12.5 percent had secondary tracheomalacia as complications of BG and EG cysts. BG and EG complications of the mediastinum affect the outcome of surgical treatment.

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The experience of treatment of 4 children with nonparasitic diaphragmatic cyst was summarized. The informatic diagnostic methods are--ultrasonography of the thoracic and abdominal cavity organs, and in the cyst presence--sceletotopy in the hepatic segments projection, roentgenography, roentgenoscopy, pneumoperitoneum, pneumothorax. All the patients were operated on. The cyst had the right-sided localization, in 2 observations the mesothelial cyst was diagnosed, and in 2--the cystic teratoma of diaphragm.

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From 1981 till 1993 yr. 144 children with the cystic pulmonary hypoplasia resided in the clinic for treatment. Except the generally accepted methods of instrumental diagnosis for 19 patients the digital subtraction angio-pulmonography was conducted for the diagnosis ascertainment. Bilateral lesion of lungs was observed in 14 patients, one of whom have died without operative treatment conduction. The surgical treatment was done for 130 patients. The combined operations were performed, as well as the classic resection of lungs. One patient was observed with broncho-mediastinal fistula, which have appeared 5 years after operation and one more was reoperated. All the patients survived the operation were discharged from hospital in satisfactory condition.

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Twenty-eight children were treated in the clinic for acute gastro-esophageal bleeding in portal hypertension syndrome. Conservative therapy has proved to be effective in 85.8% of cases. Endoscopic sclerotherapy was successfully used in 9 of the 11 patients. In ineffective conservative treatment for 24-48 hrs from the onset of bleeding, the authors consider suturing the esophago-gastric junction with ligation of the gastric vein and blocking the arterial splenic blood flow as an operation of choice.

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On the basis of the experience with treatment of esophageal atresia in 86 patients, it was established that cicatricial stenosis of the esophagus after radical correction of a defect occurs as a consequence of anastomotic suture failure, violation of the technique of placing an anastomosis, gastro-esophageal reflux. The recommendations on prevention and treatment of cicatricial esophageal stenosis are given.

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The results of observation of 12 children ranging in age from 1 to 4 mos with tentative diagnosis of pyloric stenosis are presented. The study was performed by special method, using "Aloka" SSD-280 (Japan) ultrasound apparatus. The characteristic symptoms of the disease were revealed in 9 children, diagnosis of pyloric stenosis was confirmed by means of endoscopy, palpation, and intraoperatively. The use of US is practically harmless, and can completely substitute for a roentgenologic method in detecting the given congenital pathology.

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