Хирургическое лечение детей с атрезией толстой кишки

Introduction. The purpose of the study is to discuss treatment of atresia of the large intestine at a regional center of newborn surgery in the Russian Federation. Material and methods. 12 patients (8 boys and 4 girls) with atresia of the large intestine were treated in our hospital in 2006-2015. Anatomical types of atresia of the large intestine were distributed as follows: type 1 (membrane) in 3 patients; type 2 (separation of segments connected with the fibrous bridle) in 3 patients; type 3 (separation of segments with the V-shaped mesentery defect) in 6 infants. The most frequently occurred congenital obstruction of the large intestine was localized in the area of the transverse colon of 7 patients. This was followed by patients with atresia at the descending (3 patients) and ascending section (2 patients) of the large intestine in decreasing order of frequency of occurrence. Authors of the article reported of 2 technologies of surgical therapy of atresia of the large intestine i.e. direct end-to-end anastomosis in 10 patients and end-to-side anastomosis with the formation of the external Bishop- Koop colostoma (group 3) in 2 patients. Results. The mean age of patients during the surgery amounted to 2 days - 2 ± 0.28 days (range of 1-4 days). Gestational age of patients was 38 weeks - 38.2± 0.28 weeks (range of 3440 weeks). Weight of patients at the surgery was 3054 ± 258 g (range of 1200-4800 g). Average time of surgeries amounted to 55 ± 6 minutes (range of 50-60 min). The surgeries weren’t accompanied by blood loss. Duration of the patients’ stay at the surgical hospital was 16 days in average (range of 8-28 days). No complications related to the surgery were registered in the early postoperative period. Remote (1 month-1 year) observation revealed no negative consequences of the surgery. The second stage of surgery following Bishop-Koop operations and intended for the closure of the external intestinal stoma was performed not earlier than in a month after the 1 st surgery. Conclusion. Methods of treatment of atresia of the large intestine remain controversial but anastomosis of any type is one of the best variants of the state correction.