EXPERIENCE OF TREATMENT OF CONGENITAL DIAPHRAGMATIC HERNIA AMONG BABIES.

The article presents our experience of treatment of congenital diaphrogmatic hernia at newborns and hernia of an esophageal opening of a diaphragm among children of early age. Since 2010 surgical tactics has been changed: the prolonged preoperative preparation with use of the device of high-frequency ventilation of lungs, correction of symptoms of pulmonary hypertensia is carried out, operation is carried out according to plan after stabilization of the patient in parameters of oxygenation and an acid-base state, operative treatment is executed by method of low-invasive endosurgery. Over the last 5 years 25 children with good functional and cosmetic results have been operated.

SURGERY OF CONGENITAL MALFORMATIONS IN NEWBORNS.

The development of neonatal surgery is an important task of health care system, because birth defects have been the 2nd most prevalent cause of infant mortality for many years. In order to improve the quality of care for neonates with surgical diseases we studied the main causes of neonatal deaths during the period from 1995 to 2014, on the basis of data from the Children's Surgery Department of Yakutsk. In 77% of cases, the causes of lethal outcomes in neonates with surgical pathology were conditionally preventable.

[The accessibility of high-tech medical care of newborns with surgical pathology in conditions of Far North].

The actual stage of development of public health rendering of specialized medical care is based on principles of generality, accessibility, addressness, qualitativeness, and effectiveness. However, the problem of rendering specialized medical care to population is one of most critical targets in district centers and requires immediate solution. The main mean of resolving this problem is re-hospitalization of patient in more large-scale medical institutions.

[Pathology of the gastric stump].

The endoscopic examination of 293 patients has shown that the incidence and character of diseases of the gastric stump (ulcer, polyps, carcinoma) were dependent on the underlying disease, time after the operation and severity of the duodenogastric reflux. The authors substantiate necessity of a refluxing anastomoses in gastric resection.