Kurylo G. Diagnosis and surgical management of congenital colon in infants and young children

The investigation of congenital disorders inervatsiyi colon in infants and young children. Outlined the problem is designed to histochemical investigation of the bowel wall biopsy using an enzyme-histochemical reactions and miniinvasive biopsy technologies that accurately identify high damage colon and histological variant dyshanhlionosis as well as correctly choice surgical tactics depending on age. The results of research premorbid background and analysis of pedigrees of children with dyshanhlionosis. Found that among sibs proband violation inervation colon is diagnosed. However, among the relatives of the proband dyshanhlionosis second degree relatives significantly more often there were various defects in the paternal line, and among the relatives of the third degree - on the maternal side. In children with dyshanhlionosis, manifested a different spectrum of congenital malformations, but their frequency was not large. It is shown that the treatment of uncomplicated dyshanhlionosis in young children the best method is radical surgery, which is resection of the affected segment of bowel and changed after intraoperative biopsy with clear overlapping colorectal anastomosis to a healthy colon. Treatment of children with severe course dyshanhlionosis should be two stages with their colostomy, laparoscopic possible, a healthy colon during the first phase and second phase of radical surgery. In infants with dyshanhlionosis optimal surgery is the procedure in the Soave-Boley modification, and the young children - transannal endoscopic pull-throu and laparoscopic colostomy. Rational choice of the surgical treatment of dyshanhlionosis allows in 96.1% of young children to achieve good and satisfactory in 3.9% of remote functional results.