Possibilities of intraoperative hemostasis in endoscopic choanoplasty in children

Introduction. Recently, a significant breakthrough has been noted in the surgery of congenital choanal atresia in children: new approaches, various modifications of surgical techniques of choanoplasty have reduced the percentage of complications along with achieving good clinical results in restoring nasal breathing. The outcome of surgery largely depends on adequate hemostasis. Thus, increasing its effectiveness remains relevant. Aim . Evaluation of the effectiveness of intraoperative hemostasis during choanoplasty in patients with congenital choanal atresia (CCA). Materials and methods . The study included 63 children diagnosed with CCA treated at the Veltischev Institute (Moscow). The patients were divided into 2 groups: the main group and the control group. In the main group, hemostasis was carried out by using a bipolar coagulator (power 18 W), periodic irrigation of the surgical field with 1-2 ml of 1% solution of incomplete silver salt of polyacrylic acid (total volume 10-20 ml), in combination with intravenous administration of tranexamic acid in a single dose of 15 mg/kg body weight at a rate of 1 ml/min. In the control group, only coagulation and tranexamic acid were used. Results and discussion . In the main group, the use of incomplete silver salt of polyacrylic acid reduced the average volume of blood loss by 1.3 times compared with the control group. Conclusion. The study showed that the use of incomplete silver salt of polyacrylic acid in hemostasis during choanoplasty in children with CCA is effective.