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https://doi.org/10.14300/mnnc.2022.17033

Intraoperative correction of immune response as a part of comprehensive treatment for congenital hydronephrosis in children

[Original research] [Surgery]
Vitaly Ivanovich Lapshin; Maxim Razin; Sergey Minaev; Mikhail Aksel’rov; Tatyana Borisovna Agalakova; Elena Borisovna  Dunaeva; Elena Borisovna  Dunaeva; Dmitrii Andreevich Dyakonov; Victoria Anatolyevna  Makhneva;

The study revealed several changes in the immunological parameters in 70 children aged 5–12 years with CH complicated by SP. A decrease in the number of CD3-, CD4-, CD16-lymphocytes and indicators of phagocytosis was noted with an increase in the number of CD19-lymphocytes and serum immunoglobulins. To correct the above disorders in 35 children, the method of the intraoperative correction of immune response was used, which consisted of a single injection of a bolus of Imunofan (Bionoks, Russian Federation) under the capsule at the final stage of laparoscopic intervention under the capsule in the region of the lower pole of the kidney. All patients were discharged from the hospital in a satisfactory condition in the stage of partial clinical and laboratory remission of SP. Patients were examined three months after treatment. Compared with the indicators at admission, the examination showed a significant normalization of the absolute number of NK-cells (p<0.0001) and B-lymphocytes (p=0.0229); absolute (p=0.0227) and relative number (p=0.0192) of T-lymphocytes; cells with helper functions (p=0.0026; p=0.0132) and T-suppressors (p=0.0996). High levels of serum immunoglobulins decreased with a simultaneous increase in the phagocytic activity of neutrophils (p=0.0001). Thus, the intraoperative correction of immune response by Imunofan in the complex treatment of children with CH complicated by SP provides an improvement in the immediate and long-term results of treatment.

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Keywords: congenital hydronephrosis, secondary pyelonephritis, surgical treatment, immune response, children