For the first time in the Sverdlovsk Region, doctors were awarded special prizes within the framework of the Year of the Medical Worker, announced by the Governor of the region, Yevgeny Kuyvashev. Natalya Tsap – Chief Pediatric Surgeon of the Ural Federal District, Head of the Department of Pediatric Surgery of the Ural State Medical University (USMU) was awarded in the category “Technology of the Year”.
Natalia Aleksandrovna has been in the profession for over 30 years: she combines direct work on the basis of the Regional Children’s Clinical Hospital and the Children’s City Hospital No. 9 of Yekaterinburg with teaching. Every day Natalya Tsap receives patients, performs surgeries – sometimes unique in their complexity. The most difficult in her practice in recent years were the cases when it was necessary to save the life of a child who swallowed a battery – in such situations it stops in the esophagus and burns through the esophagus and trachea.
“There were four such children in our practice. Each of them was completely individual, in each case we went slightly different paths to save their lives. Because the child cannot live with the presence of a fistula between the esophagus and the trachea – he cannot eat or breathe fully. The surgeon’s task is to separate the trachea and esophagus that have grown together with the defect and close these defects, ”said Natalya Tsap.
Ural doctors first encountered such a case in 2017 and at first did not know what first step to take to save the life of a little patient who was brought to Yekaterinburg from the region. It did not immediately become clear what exactly happened to the child – his parents did not know that he had swallowed the battery, it was revealed only on the fourth day.
“First, we placed a gastrostomy tube so that a large amount of air did not enter the gastrointestinal tract and was able to feed. And then we went to the separation of the esophagus and trachea – this was the first time in my life. Before starting this operation, I turned to the leading pediatric surgeon Alexander Yuryevich Razumovsky for advice. There was even a thought about urgently transporting the child by plane to Moscow, but only one answer was given – “Natalya Aleksandrovna, there were three such patients in Russia, two of them died. Do it yourself. ” And we did it. They disconnected, shifted the muscles with additional special implants, and this child recovered. Nursing was very difficult, ”Natalya Tsap recalls the unique operation.
Subsequent similar cases in the practice of the Ural pediatric surgeons were even more complicated. One of them happened already in 2021 – multiple surgical interventions were required, a fistula recurrence occurred:
“I again consulted with Alexander Yuryevich Razumovsky – it was at 6 am, and in Moscow – at 4 am, but he immediately said that I must“ learn to say goodbye to some organ ”. And I realized – yes, we need to risk the esophagus, remove the esophagus, but close the hole in the trachea with it. And after that, we started to have positive dynamics. The girl today has a gastrostomy, esophagostomy, but she breathes on her own, there is no threat to life now. “
Such cases from practice are remembered for a lifetime, Natalya Tsap admits:
“I even said at some stage:“ I was dying with this child. ” I would like to once again draw attention to how careful parents should be in order to prevent such cases. “
By Daria Korchak