Vakulenko M. Surgical prevention and correction of consequences of extensive resection of the intestine in children

Українська версія

Thesis for the degree of Candidate of Sciences (CSc)

State registration number

0415U001548

Applicant for

Specialization

  • 14.01.09 - Дитяча хірургія

19-03-2015

Specialized Academic Board

Д 26.003.03

Essay

There are results of surgical correction of malformation disease in 135 children, who were required resection of the intestine. Depending on the volume and bowel resection pa-tients were divided into 4 clinical groups. Group I consisted of patients (n=45) who un-derwent limited resection of the small intestine, II group (n=30) - with extensive resection of the small intestine, III group (n=35) - patients with diseases in which the ileocecal re-section of intestine, IV group consisted of patients (n=25), which was necessary to conduct extensive resection of the colon on the subtotal form of Hirschsprung's disease. There are indications to the volume of bowel resection, according to the nature of pathology and complications arising due to the disease. The patients in group I after resection of small in-testine was imposed primary enteroanastomosis in different variants. In Group II, after ex-tensive resection of the small intestine primary anastomosis was assessed in 21 patients, 7 patients initially were imposed enterostomies, and at 2 - was made programmed laparostomy. During ileocecal resection of the bowel (III group) in 22 cases enterokoloanastomosis with antire-flux protection was assessed, in 13 cases - without antireflux protection. Anatomical and functional design with antireflux protection of enterokoloanastomosis during ileocecal resection of the intestine was improved. When subtotal form of Hirschsprung's disease the primary radical surgery was performed in 3 cases, in 22 patients the operation was carried out in two stages - a colostomy (Stage 1) and radical surgery - resection of the altered part of the colon with the formation of colorectal anastomosis (Stage 2). The introduction of the anatomical and functional reconstructive operations and rehabilitation treatment aimed at preventing post-resection effects yielded in 81.3% chil-dren had good results and 19.7% - satisfactory in a long-term period.

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