Первинний коло-анальний степлерний анастомоз при хірургічному лікуванні хвороби Гіршпрунга в дітей

Abstract

Hirschsprung’s disease (HD) belongs to group of severe congenital malformations of the colon that can be only treated surgically. Various methods of radical correction HD have been evolutionarily improved. The Soave–Boley technique is considered to be the most successful, physiological and technically acceptable. Purpose – to evaluate the effectiveness of the use of stapler for primary colo-anal anastomosis as an element of Soave-Boley surgery in the surgical treatment of HD in children. Materials and methods. The analysis of surgical treatment of 125 children with various forms of HD aged from 6 months to 18 years, the formation of the primary colo-anal anastomosis was done using the Soave–Boley technique by mechanical (stapler) method. Results. In 20 patients (16.00%) among 125 with complicated course of HD, it was difficult to do radical single stage surgical treatment they required twostage treatment (stage 1) formation of the protective intestinal stoma and (stage 2) radical surgery. In the remaining 105 (84.00%) patients, single stageradical correction of HD was performed. In 1 (0.80%) of 125 patients operated by the Soave–Boley method with a primary colo-anal stapler anastomosis, in the early postoperative period was diagnosed with hematoma between pull through colon and sero-mascular pouch, which was treated conservatively. Andin one patient (0.80%) of 125 children in the remote postoperative period there was surgical complication – residual agangliosis, which was corrected by sphincteromyectomy by Lynn technique. Conclusions. Soave–Boley surgery with stapler colo-anal anastomosis is an effective method of radical correction of HD in children of different ages with one-stage or two-stage interventions. The use of a stapler for primary colo-anal anastomosis as an element of Soave–Boley surgery for the surgical treatment of HD in children with the consideration of necessary technical precautions has significant advantages over its classic methods. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: Hirschsprung’s disease, children, surgical treatment, results.