Volume 04 Issue 06-2024
45
American Journal Of Biomedical Science & Pharmaceutical Innovation
(ISSN
–
2771-2753)
VOLUME
04
ISSUE
06
P
AGES
:
45-53
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
ABSTRACT
Reducing perinatal morbidity and mortality is one of the main tasks of the maternal and child health care system.
Congenital anomalies contribute significantly to these indicators and occupy leading positions in terms of prevalence.
According to the World Health Organization, 25% of newborns are born with developmental defects. In light of this
data, increasing the efficiency of early medical care and reducing growth and development-related disorders in
newborns is crucial. Congenital anomalies of the digestive tract occupy a primary place, corresponding to 21.7%-25%.
Currently, perinatal studies of the problem of mother and child with congenital digestive tract anomalies are
considered separately, which is significant for perinatal diagnostics, the ability to predict congenital digestive tract
anomalies, and determining tactics. This is of great importance for both pediatricians and surgeons. As a first step in
Research Article
TYPES AND STRUCTURE OF SURGICAL DISEASES IN NEWBORNS
ACCORDING TO DATA FROM A REGIONAL CENTER
Submission Date:
June 14, 2024,
Accepted Date:
June 19, 2024,
Published Date:
June 24, 2024
Crossref doi:
https://doi.org/10.37547/ajbspi/Volume04Issue06-08
Mavlyanov F.Sh.
Samarkand State Medical University, Samarkand Regional Children's Multidisciplinary Medical Center,
Samarkand, Uzbekistan
Azizov M.K.
Samarkand State Medical University, Samarkand Regional Children's Multidisciplinary Medical Center,
Samarkand, Uzbekistan
Tursunov S.E.
Samarkand State Medical University, Samarkand Regional Children's Multidisciplinary Medical Center,
Samarkand, Uzbekistan
Mavlyanov Sh.K.
Samarkand State Medical University, Samarkand Regional Children's Multidisciplinary Medical Center,
Samarkand, Uzbekistan
Journal
Website:
https://theusajournals.
com/index.php/ajbspi
Copyright:
Original
content from this work
may be used under the
terms of the creative
commons
attributes
4.0 licence.
Volume 04 Issue 06-2024
46
American Journal Of Biomedical Science & Pharmaceutical Innovation
(ISSN
–
2771-2753)
VOLUME
04
ISSUE
06
P
AGES
:
45-53
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
creating a system for assessing and improving medical services provided to the younger generation, it is important to
optimize medical care for newborns with surgical diseases.
KEYWORDS
Perinatal studies, indicators and occupy leading positions, determining tactics.
INTRODUCTION
To study the types and frequency of nosological forms
of surgical diseases in newborns that required surgical
treatment within the first day of life.
METHODS
The material for the study was a retrospective analysis
of official data from annual reports of the heads of
neonatology and newborn surgery departments of the
Samarkand Regional Children's Multidisciplinary
Medical Center for the period from 2017 to 2022. The
study was multi-stage. The program and methodology
of the study are presented in Table 1.
Table 1.
Program and Methodology of the Study
Stages
Work Content
Observation
Objects and
Research Methods
Information
Sources and
Observation
Volume
I
Study of the
morbidity level of
surgical pathology
among newborns
hospitalized
Neonatology and
neonatal surgery
patients
Official data from
annual reports
(2017-2022)
II
Clinical and
statistical
characteristics of
gastrointestinal
surgical diseases in
hospitalized
newborns
Neonatal surgery
and neonatology
ICU patients
Retrospective and
prospective
controlled study of
diagnosis and
treatment results
(2017-2022)
Volume 04 Issue 06-2024
47
American Journal Of Biomedical Science & Pharmaceutical Innovation
(ISSN
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2771-2753)
VOLUME
04
ISSUE
06
P
AGES
:
45-53
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
The level of surgical pathology among newborns was
analyzed at the first stage of the study using
hospitalization data.
During the second stage of the analysis, the results of
diagnosis and treatment were examined. As a result,
the clinical-statistical characteristics of congenital
gastrointestinal surgical diseases in 335 children, which
led to hospitalization, were identified.
RESULTS AND DISCUSSION
Based on the statistical data registry from annual
reports
(2017-2022),
14,994
newborns
were
hospitalized at the Samarkand Regional Children's
Multidisciplinary Medical Center, with 2,012 infants
having surgical pathology (Table 2).
Table 2:
Number of Newborns with Surgical Diseases (2017-2022)
Hospitalization
Period
Number of the children
Other Pathologies
Urogenital System
Pathology
Total
2017
2281(91,6%)
209 (8.4%)
2490 (100%)
2018
2288 (87.5%)
326 (12.5%)
2614 (100%)
2019
2129 (82.9%)
438 (17.1%)
2567 (100%)
2020
1703 (81.7%)
380 (18.3%)
2083 (100%)
2021
2026 (77.7%)
580 (22.3%)
2606 (100%)
2022
2346 (89.1%)
288 (10.9%)
2634 (100%)
Total
12982 (86.6%)
2012 (13.4%)
14994 (100%)
It is evident that the actual incidence of surgical
diseases might be significantly higher than the
registered statistical data. The increase in the level of
medical care and the rise in morbidity are not only due
to an increase in the number of diseases among
newborns but also due to the improvement in the
quality of medical care provided. The study showed
that surgical pathology among infants and young
children (up to 1 year old) averaged 13.4%.
As the studies indicated, congenital intestinal
obstruction ranked first in the structure of morbidity
based on hospitalization data (42.1%), followed by
Volume 04 Issue 06-2024
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American Journal Of Biomedical Science & Pharmaceutical Innovation
(ISSN
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2771-2753)
VOLUME
04
ISSUE
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P
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:
45-53
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
anorectal malformations (21.5%). A significant number
of newborns had anterior abdominal wall defects and
necrotizing enterocolitis, accounting for 11.9% and 10%,
respectively (Table 3).
Table 3:
Nosological Forms of Gastrointestinal Surgical Diseases in Newborns
Final Diagnosis
Number of Infants
Jejunal Atresia
8
Ileal Atresia
42
Small Bowel Atresia, Necrosis, Perforation, Peritonitis
5
Cecal Atresia
1
Small Bowel Membrane
3
Duodenal Atresia
4
Aberrant Duodenal Vessel
1
Duodenal Membrane
10
Ladd's Syndrome
25
Annular Pancreas
18
Meconium Ileus
3
Embryonic Adhesions of the Duodenum
6
Hirschsprung's Disease, Acute Form
16
Necrotizing Enterocolitis
34
Lower ARM (Anorectal Malformation)
40
Upper ARM
31
Esophageal Atresia
25
Congenital Pyloric Stenosis
23
Gastroschisis
8
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American Journal Of Biomedical Science & Pharmaceutical Innovation
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OCLC
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Omphalocele
32
Total
335
Among the infants, there were 217 boys and 118 girls.
As shown in the table below (Table 4), the number of
patients from rural areas significantly exceeded those
from urban areas. The majority of children (79.1%) had
a normal div weight at the time of hospitalization. By
gestational age at birth, there were 251 full-term
infants, 59 preterm, and 22 post-term newborns.
Table 4:
General Characteristics of Patients
Gender
Total
Boys
217 (64.8%)
335 (100%)
Girls
118 (35.2%)
Address
City
9
335 (100%)
Village
326
Weight at Admission
Normal
265 (79.1%)
335 (100%)
Low
68 (20.3%)
Very Low
2 (0.6%)
Gestational Age
Full-term
251
335 (100%)
The study of the routing of newborns with surgical
diseases found that the vast majority of patients
(76.4%) were rehospitalized from the maternity
hospital. Within the first 48 hours of birth, 194 infants
were hospitalized. 141 patients were hospitalized more
than 48 hours after birth. 83.6% of the children
underwent surgery within 24 hours of admission (Table
5).
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Publisher:
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Table 5
Routing of Hospitalized Newborns
Pathways to Hospitalization
Number of Patients
Percentage
Rehospitalization from Maternity Ward
256
76.4%
From Home
79
23.6%
Total
335
100%
Time from Birth to Hospitalization
Number of Patients
Percentage
Within 48 Hours
194
57.9%
More than 48 Hours
141
42.1%
Total
335
100%
Time from Hospitalization to Surgery Number of Patients
Percentage
Within 24 Hours
280
83.6%
More than 24 Hours
55
16.4%
Total
335
100%
Surgical treatment was performed on 333 newborns.
Surgery was not conducted on 2 patients due to
parental refusal of the proposed treatment. Surgical
intervention was performed on 194 newborns within
48 hours from birth. The remaining infants underwent
surgery more than 48 hours after birth. From the time
of admission to surgery, 83.6% of the patients were
operated on within 24 hours, and 55 newborns were
operated on later.
The following surgical procedures were performed on
the 333 newborns (Table 6).
Table 6
Types of Operations Performed on Newborns with Congenital Intestinal
Obstruction
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Publisher:
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Operation Name
Number of
Patients
Abdominal Drainage
13
Membrane Resection of the Duodenum, Naso-Intestinal
Intubation
7
Membrane Resection of the Small Intestine
3
Partial Resection of the Small Intestine, T-shaped Ileal-Ileal
Anastomosis
19
Duodeno-Duodenal Anastomosis, Naso-Intestinal Intubation
26
Ladd's Operation
25
Partial Resection of the Small Intestine, Ileal-Ascendostomy
Anastomosis
1
Embryonic Adhesions of the Duodenum, Naso-Intestinal
Intubation
6
Laparotomy, Jejuno-Jejunal Anastomosis, Naso-Intestinal
Intubation
3
Laparotomy, Colostomy
7
Perineal proctoplasty
42
Left-sided Maydl colostomy
42
Laparotomy, cecal resection, ileostomy
1
Partial resection of small intestine, ileostomy
42
Esophago-esophagostomy
25
Laparotomy, pyloromyotomy
23
Gastroschisis repair
7
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OCLC
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1121105677
Publisher:
Oscar Publishing Services
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Omphalocele repair
32
Laparotomy, gastric perforation closure
5
Laparotomy, small intestine perforation closure,
appendicostomy
2
Laparotomy, cecostomy
1
Resection of embryonic adhesions in the abdominal cavity
1
Total
333
Naso-intestinal intubation
45
Ileostomies
45
Colostomies
50
T-shaped anastomoses
20
CONCLUSIONS
Based on the conducted research, surgical diseases
among pathological conditions in newborns constitute
13.4%. In our view, this frequency represents a
significant medical and social issue that requires
increased attention from the medical system at all
levels.
A clear classification and detailed study of the
epidemiological features of these pathologies in
different regions and population groups are essential
steps in optimizing medical care, developing effective
preventive measures, and rationally allocating
healthcare resources. Only a comprehensive approach
that considers the epidemiological, clinical, and social
aspects of this problem will achieve significant
progress in the field of neonatal surgery.
The established increase in the incidence of surgical
diseases in newborns necessitates the justification of
modern, cost-effective approaches to organizing
medical care, treatment methods, and rehabilitation of
patients. The large number and variety of surgical
operations on the digestive system performed on
newborns in the first days of life prompt the search for
ways to improve their outcomes.
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American Journal Of Biomedical Science & Pharmaceutical Innovation
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VOLUME
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OCLC
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1121105677
Publisher:
Oscar Publishing Services
Servi
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