A comparative analysis and choice of surgical tactics in pediatric Crohn’s disease

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Abstract

Introduction. Currently, surgical complications in Crohn’s disease is still one of the most serious problems in pediatric surgery. An intensive development of video endoscopic surgery contributes to the active introduction of this technology in pediatric coloproctological practice. Crohn’s disease is still one of the most complex pathologies in pediatric gastroenterology, and surgical treatment of its complications is a disputable issue among pediatric surgeons. Up to now, there are no clear indications to surgery in the refractory form of Crohn’s disease, no standardized terms and types for surgical intervention, as well as no optimal variants of surgical access.

Material and methods. A retrospective analysis of patients who had been treated surgically at departments of abdominal and emergency surgery in two pediatric hospitals in Moscow (Morozovskaya and Izmailovskaya ) was carried out. 39 children with Crohn’s disease, aged 4–17 year, were included in the study. All patients had standard clinical examination: clinical examination with anamnesis, laboratory and instrumental diagnostics.

Results. The obtained results have shown that laparoscopic interventions have a number of advantages, such as less traumatic surgery, reduced exposure to anesthesia and shorter intestinal stimulation, less stay in ICU, shorter hospitalization as well as more rapid rehabilitation period.

Conclusion. The performed assessment of outcomes after surgical treatment of children with complicated Crohn’s disease helped to develop indications for the selection of surgical technique in the ileocecal form. Thus, the obtained results improved outcomes in children with complicated Crohn’s disease because of the outlined indications for surgery and surgical tactics when minimally invasive techniques are more preferable.

About the authors

I. V. Poddubniy

Morozovskaya Children’s Clinical Hospital; А.I. Evdokimov Moscow University of Medicine and Dentistry

Author for correspondence.
Email: igorpoddubnyi@yandex.ru

Igor V. Poddubniy, professor, head of chair of pediatric surgery

Moscow, 127473

Moscow, 119049

Россия

O. V. Scherbakova

Pirogov Russian Medical University

Email: fake@neicon.ru

Moscow, 117997

Россия

V. O. Trunov

Pirogov Russian Medical University

Email: fake@neicon.ru

Moscow, 117997

Россия

M. Yu. Kozlov

Morozovskaya Children’s Clinical Hospital

Email: fake@neicon.ru

Moscow, 127473

Россия

S. R. Manukyan

Morozovskaya Children’s Clinical Hospital; А.I. Evdokimov Moscow University of Medicine and Dentistry

Email: fake@neicon.ru

Moscow, 127473

Moscow, 119049

Россия

Ya. A. Galkina

Morozovskaya Children’s Clinical Hospital

Email: fake@neicon.ru

Moscow, 127473

Россия

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