This journal is
indexed in Scopus
Year 2014 Vol. 22 No 4
THE POSSIBILITIES OF SURGICAL REHABILITATION IN CHILDREN WITH PROLONGED DISABLED INTESTINE SYNDROME
Kharkov National Medical University
Objectives. To determine the possibilities of surgical rehabilitation of patients with prolonged disabled intestine syndrome due to the staged restoration of the intestinal passage.
Methods. The treatment results of two children with terminal ileostomy previously formed at early age are presented in the study. Restoration of natural intestinal passage was conducted in children at the age of 8,5 and 16,5 years, respectively. Surgical rehabilitation of patients was held in the pediatric surgery clinic of Kharkov National Medical University at Kharkov Regional Clinical Hospital N1. After surgery completion the short- and long-term results and the quality of life have been studied.
Results. Carrying out of medical measures was directed to the main pathogenic features of the morphofunctional violations, which develop due to the prolonged disabled intestine syndrome. Medicamentous stimulation, hydrotraining of non-functioning segments of small and large intestine, energy disorders correction, electrical stimulation have been carried out. Surgery included formation of direct T-shaped anastomosis with preserving stoma at the first stage. After anastomotic healing the training of fistula obturation with a gradual increase in duration have been conducted. After regular unaided defecation appearance the stoma is closed. Thus, the restoration of full natural intestinal passage in patients with terminal enterostomy after 8.5 and 16.5 years has been successfully performed with the achievement of regular unaided defecation in the long-term period. It testifies to the reversibility of morphofunctional changes developing due to the prolonged disabled intestine syndrome.
Conclusions. The developed complex technique of staged rehabilitation of non-functioning intestine segments allows achieving the complete rehabilitation of disabled intestine segments during the prolonged period of absence of chyme passage. The rarity of such observations is considered to be of great interest for a wide range of surgical community.
- Vorob'ev GI, Zhuchenko AP, Filon AF, Kitchieva GM. Kolit otkliuchennoi tolstoi kishki [Colitis of disabled colon (Literature review)]. RZhGGK. 2008;18(5):65-70.
- Dan'shin TI, Maksakova IS, Pritula VP. Khirurgichne likuvannia novonarodzhenikh z vadami rozvitku kishok [Surgical treatment of infants with malformations of the intestines]. L'vivs'kii Medichnii Chasopis. 2003;9(4):44-48.
- 3. Fofanov OD. Deiaki aspekti khirurgichnogo likuvannia vrodzhenoõ obstruktsiõ kishok u d?tei [Some aspects of the surgical treatment of congenital obstruction of the intestines in children]. Khirurgiia Ditiachogo Viku. 2012;(1):149-58.
- Giul'mamedov FI, Shlopov VG, Giul'mamedov PF, Mamedov NZ. Rekonstruktivno-vosstanovitel'nye operatsii u bol'nykh s ileokolostomoi [Reconstructive surgery in patients with ileocolostomy]. Sevastopol', RF: Veber; 2001. 208 p.
- Son DN, Choi DJ, Woo SU, Kim J, Keom BR, Kim CH, Baek SJ, Kim SH. Relationship between diversion colitis and quality of life in rectal cancer. World J Gastroenterol. 2013 Jan 28;19(4):542-49.
- Rodrigo Goulart Pacheco, Christiano Costa Esposito, Lucas CM Muller, Morgana TL Castelo-Branco, Leonardo Pereira Quintella, Vera Lucia A Chagas, Heitor Siffert P de Souza, and Alberto Schanaider Use of butyrate or glutamine in enema solution reduces inflammation and fibrosis in experimental diversion colitis World J Gastroenterol. Aug 28, 2012; 18(32): 4278-87.
- Gassan TA. O probleme kishechnykh stom u detei perioda novorozhdennosti [On the problem of intestinal stomas for children of newborn period]. Detskaia Khirurgiia. 2002;(4):41-44 .
61051, Ukraina, g. Khar'kov, Ul. Klochkovskaia, d. 337 A, KUOZ Oblastnaia detskaia klinicheskaia Bol'nitsa ¹ 1, Khar'kovskii natsionvl'nyi Meditsinskii universitet, kafedra detskaia khirurgii i detskoi anesteziologii,
Pashchenko Konstantin Iur'evich
Pashchenko K.Y., a post- graduate student of the chair of pediatric surgery and pediatric anesthesiology of Kharkiv National Medical University