Treatment of children with chemical burns of esophagus with various etiology

Background. At present continuous growth of pathology after chemical burns of the esophagus (CBE) in children is observed. The lack of uniform statistical information about this pathology in domestic and foreign literature considerably complicates studying of that nosology. The purpose of the present study is optimization of treatment techniques in children with chemical burns of the esophagus with various etiology and generalization of our own experience of treatment in this contingent of patients.Material and methods. We have analyzed treatment techniques in 147 children with CBE with various etiology and severity for last decade. The general method of diagnosis was esophagogastroscopy performed within the first day of hospitalization. Endoscopic examination showed following stages of CBE: I stage in 36 patients, II stage in 67 cases and 44 patients had III stage.Results. In children with I stage CBE erosive inflammatory process was controlled by conservative therapy in 10–14 days. This cohort of patients from 3–4 day of disease was considered outpatient. Patients with II stage CBE erosive inflammatory changes were treated by complex therapy on 21–23 day. There were surgical complications observed.    Patients with III stage CBE referred in most severe condition. Length of conservative treatment for erosive  inflammatory process was 1 month. In this group of patients we observed complications in 24 cases (16.3%) and bougienage was performed according to different techniques. Duration of bougienage varied from 3 to 24 months. Later on all children were observed out-patiently according to the place of residence.Conclusions. Performed therapy should be complex and differentiated regarding the severity of trauma. Complex treatment technique designed in our hospital is quite efficient and could be recommended for clinical application. All children suffered from CBE are to be followed up refularly. Preventive medical check-up should include endoscopic examination, once every three months to avoid possible esophageal stenosis development. Preventive treatment for esophagitis is mandatory during the period of preventive medical check-up

INTEGRATED MANAGEMENT OF OESOPHAGEAL CAUSTIC BURNS IN CHILDHOOD

The paper presents the analysis of treatment of 147 children with different degrees of chemical burn of the esophagus. It is based on a complex scheme of treatment depending on the nature and original extent of manifestations of chemical injury of the esophagus, the clinical features of its course in the dynamics and effectiveness of remedial measures. A comprehensive approach to treatment with observance of principles of waste treatment policy has allowed to considerably reduce the number of early and delayed complications of chemical burns of the esophagus in children, to prevent mortality, effective prevention and treatment of post-burn cicatricial stenosis of the esophagus

CORRECTION DYSBACTERIOSIS IN REHABILITATION PROGRAMS FOR CHILDREN UNDERGOING SURGERY ON THE COLON AND ANORECTAL ZONE

Rehabilitation of children undergoing surgery for colon and rectum is an important issue of pediatric surgery. Its relevance is due to the widespread development of these anomalies requiring surgical correction –  1:4000–5000 newborns. In all patients with this disease is marked by inflammatory changes in the intestinal mucosa. Use of      73  antibacterial drugs in the pre-and postoperative periods in 100% of cases, causes the development of  intestinal dysbiosis.Dysbiosis uniqueness is manifested in the fact that this disease is in the interests of doctors of different specialties. Traditional methods for correcting violations mikrobiotsinoz gut is not always sufficiently effective in surgical patients. The purpose of this study to optimize the treatment and prevention circuit dysbacteriosis in surgical patients

POSTOPERATIVE REHABILITATION OF CHILDREN WHO UNDERWENT A SURGERY ON THE COLON AND ANORECTAL AREA

Aim. The research was carried out to create and evaluate the effectiveness of the rehabilitation algorithm of children who underwent a surgery on the colon and anorectal area.Materials and methods. We have experience in rehabilitation of 245 patients aged from 8 months to 15 years with anorectal  agenesis and Hirschsprung's disease. To assess the effectiveness of  the proposed algorithm of rehabilitation measures we formed 2  identical groups according to age, sex and nosology indicators. The  main group consisted of 136 children with abovementioned  pathology. Rehabilitation measures were carried out according to the developed algorithm. It included early bougienage, general and local  physiotherapy, correction of intestinal dysbiosis by selective  decontamination, relief of water-electrolyte and metabolic disorders. The control group consisted of 109 patients. Rehabilitation was carried out according to the traditional methods. Results. When comparing the results of rehabilitation, the following data were obtained: therapeutic and preventive bougienage was  carried out for 18.34±1.29 months in patients of the control group  and for 9.56±0.94 months in children of the main group. The  duration of anal sphincter insufficiency treatment in the control  group was 23.48±1.95 months and only 11.29±1.07 months in the main group. The timing of the correction of dysbiosis in patients of the control group was 36.25±2.17 months and 14.36±1.14 months  in children of the main group. The duration of electrolyte disorders  and metabolic disorders correction in the control group was 14.16±0.57 months and 6.34±0.28 months in the main group.Conclusion. The application of the developed algorithm of rehabilitation measures made it possible to reduce their duration by  more than 2 times according to all the studied criteria. It allows us  to recommend the created rehabilitation algorithm for wide clinical application