Surgical Treatment of the Funnel Chest Deformation at the Children

Introduction: Funnel chest deformation (FCHD) is the most common malformation of the chest. This anomaly appears as the cosmetic and functional disorders of the cardiovascular and respiratory systems. Its main characteristic feature is tendency to progression, closely linked with the growth and age of children. Purpose: To analyze results of surgical treatment at the children with FCHD, using minimally invasive method of thoracoplasty. Materials and methods: The research group included 21 children with FCHD at the age from 4 to 17 years. Symmetrical shape of deformation was revealed in 14 patients (66.6%), the asymmetric shape was revealed in 5 (23.8%) patients, the FCHD – in 2 children (9.5%). Preoperative examination included: routine clinical laboratory research, spirography, electrocardiography, echocardiography, chest radiography in the frontal and lateral projections and computed tomography. All patients underwent thoracoplasty with using method D. Nuss. Results: The period of supervision covered from 6 months to 4 years after surgery operation. Good results were obtained in 17 (80.96%) cases; satisfactory – in 3 cases (14.28%), unsatisfactory – in 1 case (4.76%). Conclusion: Surgical treatment of FCHD with using innovative in Ukraine method of retrosternal metal fixators – is vital importance direction in thoracoplasty, having numerous advantages, compared with resection techniques, as well as minimally invasive and a good cosmetic effect

Scientifical-methodical background system of medical students’ education from discipline child's surgery, orthopaedy and traumatology in Ukraine

Improvement preparation of specialists is a national task, standing before specialists of a higher school. In the conditions of the higher medical education reformation and innovative transformations of the society in Ukraine increasing requirements to the quality of doctors’ preparation. Requirements to a quality of preparation doctors increasing constantly, that carried out to the search of new forms and methodologies of educational process. Standartization of educational process, using different forms of educating, should be focused on the maximal realization of self-preparation activity and initiativeness of students, which are laying on a basis of Bologna process. Future doctor is, foremost, a specialist, which must be able to make a decision oriented on the life and health of his patients. The important task at the creation of any program is development the system of estimation knowledge and skills of students in points. Current, intermediate and final control is documented in the individual plan of educational process of student. In this document, converting the amount of points is carried out estimations by a scale ECT. Fungal development in the area of medical knowledge and proposes of an innovative transformations of society should provide a new system of requirements and education tasks. Perfection of the teaching methods, development and progress of new forms of teaching, acquire on a modern stage an important value in the student preparation. On the condition of observance all enumerated requirements, after graduation from the institution, government should get a formed skilled specialist capable independently and together with colleagues to accept the self-weighted decisions in a certain real situation, using in their professional activity those high spiritual qualities, which chould formed and developed his teachers in the process of educating, taking into account changes in our society

Application of Near-infrared reflectance spectroscopy in the diagnosis of varicocele in children and adolescents

Varicocele is a venous anomaly characterized by the enlargement of the plexus of veins in the testicle. In pediatric cases, indications for surgical intervention in varicocele include palpable dilatation of the enlargement of the plexus veins, intermittent pain in the ipsilateral testicle, and a 20% reduction in size of the ipsilateral testicle compared to the contralateral healthy one. The limitations of evaluating these criteria and the need to assess semen parameters prompt clinicians to explore new diagnostic methods for timely surgical interventions in adolescents. One such promising study involves Near-infrared reflectance spectroscopy (NIRS) in the Near-infrared range. The aim of the research is to evaluate the diagnostic capabilities of NIRS in children with varicocele to determine the indications for surgical intervention. The study included 65 boys aged 11 to 17 years with left-sided grade III varicocele (main group) and 29 healthy boys as a control group. Monitoring of regional oxygen saturation (rSO2) of testicular tissues was conducted using optical spectroscopy. NIRS examination of testicular tissues in both study and control groups showed statistically homogeneous data for regional oxygen saturation in the healthy (right) testicle. However, the NIRS study revealed significantly lower oxygen saturation (rSO2) in the testicular tissue of the left testicle in patients with varicocele compared to the control group. The diagnostic significance of the difference in bilateral NIRS monitoring Δ rSO2 >13% reliably characterized the presence of testicular hypotrophy by more than 20% compared to the healthy contralateral side (AUC=0.64, 95% CI (0.505-0.775), sensitivity – 79%, specificity – 50%, p=0.042). Δ rSO2 >11% values indicated disturbances in spermogram related to oxidative stress (AUC=0.702, 95% DI (0.51-0.88), sensitivity – 82%, specificity – 61%, p=0.031). Therefore, NIRS study data have potential valuable information for the diagnosis and selection of treatment for varicocele in children. The research utilizing Near-infrared Reflectance Spectroscopy revealed a significant potential of this method for diagnosing and assessing the impact of varicocele on the microcirculation of testicular tissue in children. The diagnostic significance of the difference in bilateral monitoring using this non-invasive technique in determining the state of testicles and the possibility of addressing the question of the necessity of surgical intervention is established