DAIGNOSIS END COMCLATED TREATMENT OF SUBCLINICAL AND DECOMPENSATED CHRONIC COLOSTASES IN CHILDREN

Аннотация

In 288 patients with subclinical and decompensated CHC, cardiac, clinical and radiological and additional examination complexes were carried out. Various organic causes were identified, due to anatomical, muscular and functional disorders of the distal (large intestine) LI and their results were generally assessed in the ball system. In this case, the total, over 12 points and conservative treatment is ineffective, the relative indications to the operation were determined. If more than 18 points, and revealed additional bends, lengthening, narrowing, incomplete fixation, rotation and rigidity of the LI, with clinical complete violations of the motor-evacuation function of the LI, direct indications for surgical treatment were determined. 250 (86,8%) patients had good results from complex conservative treatment. In 26 (13,2%) patients, indications for surgical treatment were determined with: no effect of prolonged ongoing conservative treatment, an increase in the phenomena of chronic colonic obstruction with decompensated flow and a progressive worsening of the patient's condition. When choosing the methods of operation, the age of the patients, the nature and localization of the pathology of the LI were taken into account. In children under 3 years, the Delatorre-Mandragon method was performed by transanal access; preschool-age method - Soave-Lenyushkin's method with abdominal perineal and in older children - resection and fixation of TK with laparatomy access. The nature of the operation was: resection of the elongated or narrowed LI zone with the creation of "colo-anal" or "colo-colo" anastomoses with fixation of pubescent "transversogastropexy" and rotated parts of the intestine in order to restore normal anatomical structures and transient functions of it. Complications in the early postoperative period was not noted.