Surgical treatment of anomalies of fixing of left half large intestine at children

The purpose of surgical interventions at anomalies of fixing of the left bend colon at children is creation of physiological fixing of a thick gut within the anatomic sheaves warning displacement and omission of segments of a intestine in a combination to a resection of its superfluous segments

Treatment of pilonidal sinus in children

The incidence of pilonidal sinus (PS) is 26 cases per 100,000. Despite the great amount of proposed surgical techniques, the frequency of disease recurrence remains high. One of the problems of surgical treatment is the need to eliminate the soft tissue defect after PS excision, which is the main substrate that leads to longer treatment duration, long-term incapacity, difficult return to normal daily activities and decreasing of the quality of life. Therefore, determining the methods of treatment of PS in children, which will help reduce the number of complications and relapses, reduce the duration of hospitalization, remains relevant

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

The functional state of rectum sphincters in children with congenital colon malformations

Мета роботи – вивчити функціональний стан внутрішнього та зовнішнього сфінктерів прямої кишки за показниками аносфінктероманометрії в дітей, оперованих із приводу вроджених вад ободової кишки неагангліонарного генезу. Матеріали та методи. Проаналізовано результати показників аноманометрії у 87 дітей, оперованих із приводу вроджених вад ободової кишки. Результати та обговорення. Вивчено базальний тиск внутрішнього анального сфінктера, ректоанальний інгібіторний рефлекс, силу скорочення анальних сфінктерів, поріг ректальної чутливості, мінімальний об'єм повітря для розслаблення внутрішнього анального сфінктера, поріг для постійного позову до дефекації, максимально витримуваний об'єм, тест експульсії балончика у хворих із доліхосигмою – 61 дитина, із хворобою Пайра – 24 пацієнти та синдромом Хілаїдіті – 2 випадки. Висновки. Вагоміші порушення сфінктерного апарату прямої кишки відбуваються у випадках ізольованої доліхосигми з розширенням прямої кишки, порівняно з іншими видами хронічного товстокишкового стазу, що слід враховувати під час оперативного втручання. The aim was to researh a functional state of rectum internal and external sphincters using anosphincteromanometry indicators in children with congenital colon malformations after surgery. Materials and methods. Anorectal sphincter manometry indicators in 87 children after surgery for congenital colon malformations were analyzed. Results and discussion. Basal pressure of the internal anal sphincter, rectoanal inhibitory reflex, contractions of the anal sphincter, the threshold of rectal sensitivity, the minimum volume of air to relax the internal anal sphincter, the threshold for permanent claim on defecation, maximum tolerable volume, expulsion test in children with dolichosigmoid (61 children), children with Payre's disease – 24 cases and Cyilaiditi's syndrome (2 children). Conclusions. It is proved that the greatest functional disorders of rectum sphincter apparatus observed in children with dolichosigmoid in combination with the expansion of the rectum. Anorectal sphincter manometric data should be considered when choosing surgery