According to the results of a retrospective study, a high frequency of late diagnosis of HD was established (59.46% of patients), which led to many preoperative complications and the serious condition of patients. A high frequency of postoperative complications (22.67%) and reoperations (16.0%) was revealed. The developed diagnostic algorithm made it possible to identify the type, severity and causes of FI. True FI was found in 68.75% of children, pseudoincontinence in 31.25% of patients. 18.75% of patients had III degree of incontinence. It was established that the most frequent causes of FI among children with HD were the absence of a feeling of stretch of the neorectum (in 35.29% of patients) and hypermobility of the colon (17.65% of patients), among patients with ARM the most frequent cause was insufficiency of anal sphincters (42 .86% of patients). In FI caused by postoperative insufficiency of the internal anal sphincter, good functional results are obtained from the proposed method of minimally invasive surgical correction by intraanal submucosal implantation of a volume-forming gel. The method is completely safe for children. Its effectiveness is confirmed by a significant increase in basal anal pressure after its use from 8.22±2.12 to 18.6±4.2 mm Hg. (p˂0.05) and a decrease in the index of incontinence according to the Cleveland scale from 11.8±2.6 to 4.05±0.92 points (p˂0.02). The expediency and proven effectiveness of the use of a metabolic and energizing L-carnitine-containing drug in the postoperative period in children with HD and ARM have been established. Its use leads to an increase in the content of glutathione redox system enzymes - glutathione reductase by 2.23 times, glutathione peroxidase by 2.12 times, glutathione transferase by 2.98 times. L-carnitine potentiates the increase in the level of ATP (OR=2.82; 95% CI - 0.979-10.653), contributes to the normalization of metabolites of energy metabolism (increase in the content of pyruvate and decrease in the content of lactate and lactate dehydrogenase). For the first time, a method of minimally invasive surgical correction of FI caused by postoperative insufficiency of the internal anal sphincter by intraanal submucosal implantation of a volume-forming gel was proposed and implemented. The effectiveness and safety of using this method of surgical correction has been proven. Scientifically substantiated and proven effectiveness of the application of the bowel management program for the conservative treatment of children with postoperative FI. It was shown that in patients who fully followed the program, the average index of incontinence according to the Cleveland scale was significantly reduced and there were no indications for further surgical treatment of FI. For the first time, algorithms for the diagnosis and treatment of postoperative FI were developed, which made it possible to determine the severity, type and specific cause of incontinence and to choose the most pathogenetically justified treatment tactics for each specific patient. For the first time, a scale adapted to this pathology and to the social, educational, and cultural characteristics of the residents of Ukraine was proposed and implemented to assess the QoL in children operated on for CCP. In addition, for the comparative evaluation of the QoL, degrees of its severity are highlighted. New data were obtained on the QoL of children operated on for various variants of CCP. It was established that under the influence of differentiated complex treatment of postoperative complications of CCP, it was possible to significantly improve the QoL of children, which was expressed in a significant increase in the average score according to the results of the survey. New scientific data were obtained regarding violations of bioenergetic processes in the examined children, as evidenced by a decrease in the content of ATP in the blood serum, manifestations of lactic acidosis (an increase in the ratio of lactate/pyruvate and the level of lactate dehydrogenase). The effectiveness of inclusion in the rehabilitation complex in the postoperative period in children with HD and APM of L-carnitine-containing drug of metabolic action has been proven. Key words: Hirschsprung’s disease, anorectal malformations, complications, fecal incontinence, diagnosis, treatment, colorectal pathology, results, quality of life, children. Branch – medicine.
