Surgical treatment of the adhesive interstinal obstruction in children

Introduction. Adhesive intestinal obstruction (AIO) is one of the most difficult and unsolved problems of the abdominal surgery in children. Aim of the study. To explore the possibility of using hyaluronic acid solution for the treatment of intraperitoneally adhesions in children. Methods. 84 children were operated on AIO. The children were divided into two groups. HAS was not used in I group (56 patients). HAS was used in II group (28 patients). The follow-up of children from 1 to 4 years. From 84 patients on AIO: 21 (25 %) operated on for early adhesive intestinal obstruction, 63 (75 %) – on late adhesive intestinal obstruction. Recurrent AIO was in 12 (14,29 %) children. Results. In the I group (56 children) in the first year after surgery with adhesion syndrome turned 13 (23,21 %) children, up to 4 years - 20 (35,71 %) patients. In the II group (28 children) adhesion syndrome (cured conservatively) over 3 years postoperative period turned 2 (7,14 %) patients, indicating the effectiveness of hyaluronic acid solution for the purpose for treatment of the adhesions abdominal cavity in children. Conclusion. The hyaluronic acid solution is effective in the treatment of adhesive intestinal obstruction in children and is accompanied by a recurrence of the adhesion syndrome 7,14 % (n=28 children) on the difference in the group without using it – 35,71 % (n=56 children)

Оптимізація хірургічного лікування спайкової хвороби у дітей

Adhesive disease is a term used to describe conditions associated with the formation of an adhesive process in the abdominal cavity as a result of a number of reasons, the main of which is mechanical damage to the parietal and visceral peritoneum and it is characterized by varying degrees of pain and frequent adhesions.Спайкова хвороба – термін, який використовується для опису станів, пов’язаних з утворенням адгезивного процесу в черевній порожнині в результаті ряду причин, основною з яких є механічне ушкодження парієтальної та вісцеральної очеревини, і характеризується різним ступенем вираженості больового синдрому та частими виникненнями спайкової кишкової непрохідності

Slow transit constipation with dolichosigmoid in children – possibilities of surgical treatment

Introduction. Chronic constipations in children occupy one of the leading places in pediatric gastroenterological practice. Conservative treatment if effective in 90-92%. Although, children with refractory slow transit constipations caused by dolichosigmoid in case of ineffective medical treatment require other ways to solve the problem, surgery may be one of them. Aim of the Study. To elaborate effective methods of surgical treatment of dolichosigmoid in children. Methods. The results of surgical treatment of 61 children with dolichosigmoid aged from 6 to 18 have been analyzed. The children were divided into two groups: I group (n = 32 children) – surgical treatment by means of resection of the sigmoid colon was analyzed; ІІ group (n = 29 children) – the efficacy of the suggested surgery was analyzed, long-term functional results were studied, clinical efficacy of the applied methods was evaluated. Rectal biopsy was performed, irrigoradiographic examinations were estimated, the indices of anosphincterometry were studied. Results. According to the findings of radiologic examinations dolichosigmoid in children should be classified into isolated and combined with dilation of the rectum. In case of dolichosigmoid with dilated rectum hypogangliosis is found histologically. Conclusions. During surgical treatment of dolichosigmoid in children with dilation of the rectum the operation of Soave-Boley endorectal pull-through is recommended to be performed. In case of isolated dolichosigmoid in children the operation of sigmoidectomy is indicated with descendorectal end-to-end anastomosis with formation of distal colon ligament