ВЛИЯНИЕ ЭКСТРААБДОМИНАЛЬНОГО РАСПОЛОЖЕНИЯ ПЕЧЕНИ НА ТЕЧЕНИЕ ПОСЛЕОПЕРАЦИОННОГО ПЕРИОДА У НОВОРОЖДЕННЫХ С ОМФАЛОЦЕЛЕ

Abstract

Objective of the study: to evaluate the effect of extra-abdominal liver location on the postnatal status of a newborn with omphalocele. Materials and methods of research: a single-center retrospective-prospective cohort continuous non-randomized controlled study was carried out for the period from September 2017 to December 2020. The study involved 110 newborns diagnosed with omphalocele and underwent surgical treatment from August 2007 to April 2019. 2 groups were formed from this cohort of patients: the 1st main group (63 children) – newborns with liver in omphalocele, the 2nd control group (47 children) – newborns without liver in omphalocele. Results: the prevalence of viscero-abdominal disproportion in newborns with omphalocele was 27% (p=0.001) in the 1st group of children, statistically significant compared with the 2nd group. In the 1st group, the duration of stay in the intensive care unit (ICU) significantly exceeded the periods in the 2nd group – 6 (4; 15) versus 3 (0.5; 6) days, p=0.01. In the postoperative period, the development of pulmonary hypertension prevailed in the 1st group – 22% of cases, in the 2nd group – 6% (p=0.032). The average time of transition to full enteral nutrition in both groups was statistically significantly different (11 [8; 19] versus 10.5 [6; 12] days, p=0.012). The cosmeticity of the abdominoplasty results was assessed as good in two groups – 80% and 94%, respectively, p=0.171. Conclusion: when choosing the tactics of surgical treatment, it is necessary to take into account the effect of the extra-abdominal location of the liver in the postoperative period. In the presence of liver in omphalocele, in a greater percentage of cases, a viscero-abdominal imbalance, and a pulmonary hypertension develop, the duration of the postoperative period in the ICU and in the hospital and the period of transition to enteral autonomy increase.