Borys O. Improvement of the diagnosis and surgical treatment of necrotizing enterocolitis in newborns

The thesis devoted for the improvement diagnostics and optimization the surgical management of newborns with necrotizing enterocolitis. The work based on the results of the diagnosis and treatment of 111 newborns with necrotizing enterocolitis. Among these patients, 79 (71.2%) newborns were operated and 32 (28.2%) received the conventional treatment. The post-operative lethality was 22.8%. The prognostic value of the results of clinical, laboratory and instrumental methods of examination relative to the severity of damage in necrotizing enterocolitis has been determined. The significance of examination results in diagnosing the severity of the disease has been proven. High informative value of determining the levels of inflammatory mediators and Doppler ultrasonography as non-invasive diagnostic methods has been confirmed. The use of Doppler sonography before surgery allows to detect circulatory disturbances in the intestinal wall before the occurrence of perforation allowing to perform surgery at the most optimal time as well as to prevent peritonitis. It has been proposed to include drugs with anti-cytokine properties (pentoxifylline) in the complex of conservative therapy; it will allow reducing the negative influence of mediators of the inflammatory response and, consequently, improving the clinical course of the disease. The use of intraoperative Doppler sonography will allow to clearly defining the boundaries of healthy and damaged intestine; it will enable to apply primary anastomosis as well as to prevent intestinal stoma.