Novosti
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This journal is indexed in Scopus |
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Year 2023 Vol. 31 No 6
SCIENTIFIC PUBLICATIONS
M.D. LEVIN 1, 2, V.I. AVERIN 1, 3, YU.G. DEGTYAREV 1, 3
DIAGNOSIS AND TREATMENT OF RECTAL ATRESIA
State Institution "Republican Scientific and Practical Center of Pediatric Surgery" ¹, Minsk, Republic of Belarus,
Dorot-Netanya Geriatric Medical Center, Israel ²,
Belarusian State Medical University ³, Minsk, Republic of Belarus
Objective. It is known that patients with rectal atresia (RA) or stenosis (RS) have a normal anal canal. The narrowing or complete atresia is located a few centimeters proximal to the dentate line. The ARM-Net Consortium authors analyzed 36 (1.3%) of 2619 patients with anorectal malformations: RA (n = 18) and RS (n = 18). They emphasize that due to the low level of evidence, it is impossible to judge the benefits of a particular treatment method.
Methods. The purpose of this study is to review the diagnostic methods used to evaluate RA/RS. A total of 18 radiological studies of RA/RS were identified, but 4 were excluded because the diagnosis was not consistent with the clinical and/or radiological findings. We used a previously developed x-ray method, as well as studies on the anatomy and physiology of the anorectal zone.
Results. In 8 cases, radiological data indicated the presence of a septum not in the rectum, but in the anal canal approximately 1 cm from the anus. In 6 cases, on radiographs, the distal contour of the intestine was located at the level of the pubococcygeus line, as is normal. Consequently, the obstruction was in the anal canal, but since conditions were not created to open the upper part of the anal canal, it was impossible to judge the level of obstruction.
Conclusion. The study showed that RA/RS is not located in the rectum, but in the anal canal approximately 1 cm from the anus and is represented by the septum. This makes it possible to excise the septum through anal access without damaging the anal canal. Methods of diagnosis and treatment are described.
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220116, Republic of Belarus,
Minsk, Dzerzhinsky Ave., 83,
Belarusian State Medical University,
Department of Pediatric Surgery,
tel. office: +375 017 290-49-23,
e-mail: averinvi@mail.ru,
Averin Vasily Ivanovich
Levin Mikhail Davidovich, MD, Radiologist at the State Geriatric Center Dorot, Netanya, Israel.
https://orcid.org/0000-0001-7830-1944
Averin Vasily Ivanovich, MD, Professor, Head of the Department of Pediatric Surgery, Belarusian State Medical University, Minsk, Republic of Belarus.
https://orcid.org/0000-0003-3343-8810
Degtyarev Yuri Grigorievich, MD , Professor, Head of the Department of Pediatric Surgery, Institute of Advanced Training and Retraining of Healthcare Personnel, Belarusian State Medical University, Minsk, Republic of Belarus.
https://orcid.org/0000-0002-2696-4989