Sil'chenko M. Staged surgical treatment of Hirschsprung's disease in children.

228 children which were on treatment on occasion the different forms of Hirschsprung's disease (HD) from 1981 to 2005 year were included in research. Was offered and grounded the new looks and principles of staging treatment of HD in basis of which the fixed severity of current of this vice. Radical surgical operation without forming of colostomy was conducted in 165 (72,4%) children. In 11 (4,8%) patients after uneffective correction of HD the repeated one-staged operation were conducted in other clinics. At 52 (22,8%) children with heavy current of HD as the stage of treatment were concluded protective colostomy. Was developed and improved the methods of forming of colostomy as variant of the first stage of surgical treatment of HD in children. After forming of colostomy radical operations did at the improvement of the common state of patients (liquidation of anaemia, hypotrophy, diminishing of symptoms of enterocolitis and corrections of concomitant vices) in terms from 6 months to 2 years. Was investigational efficiency of the offered modification of operation of Boley with the primary forming of colorectal anastomosis for staging operations. Was well-proven dependence of volume of colon resection on age and anatomic form of HD. First proposal variant of operation with forming functionally advantageous small-intestinal reservoir after total colectomy. First was offered, grounded and executed extensive colon resections with the reconstructive and plastic forming of valvular mechanism of intestine. The differentiated approach to treatment of such patients allowed to reduce postoperative lethality 0,4%, to obtain in 215 (94,7%) patients good and in 12 (5,3%) - satisfactory functional results.