SURGICAL APPROACH TO TREATMENT OF PEDIATRIC DOLICHOMEGACOLON

Aim. To determine the volume of surgical intervention in pediatric dolichomegacolon depending of the damaged part of the colon. Materials and methods. The results of examination and treatment of 24 children at the age of 2 to 14 years who were treated for dolichomegacolon from 2006 till now are presented in the paper. There were 15 (62,5%) boys and 9 (37,5%) girls. All children were admitted to the hospital with the symptoms of acute abdomen: acute appendicitis, acute intestinal obstruction, abdominal pain syndrome. Examination was carried out by the accepted clinical standards. Results. Ten (41,7%) children were operated using the technique of length, colon position correction, 14 (58,3%) - the technique of subfascial resection of the distal part of the colon including rectum. Six months later, 2 (20%) patients operated with the technique of length, colon position correction had resumed constipations that was considered as an unsatisfactory result. Twelve months later, 1 (7,1%) patient had stenosis of the zone of colonic anastomosis with constipation relapse that was also regarded as an unsatisfactory result. Conclusions. In patients with dolichomegacolon accompanied by dysplasia of colonic wall nervous apparatus, surgical technique of length, position correction is not always effective. Remission preserving for the first 6 months after the surgery is associated mainly with resection of decompensated parts and temporary efficient propulsion of the above lying colonic parts, of the remaining distal part of sigma and rectum involved into the process and having dystrophic changes in the wall that is the reason of frequent constipation relapses.

Dolichomegacolon, surgery, children