Ростовский государственный медицинский университет, Ростов-на-Дону, Российская федерация surgical correcTion oF recTal aTresia WiTh recTo-VesTiBular FisTula chepurnoy m. g., matveev o. l., Dadayan a. g., astakhov r. e., Kolesnikov V. V. rostov state Меdical university, rostov-on-Don, russian FederationПодвергнуто сравнительному анализу две группы больных атрезией прямой кишки с ректовестибулярным свищом, оперированных из переднепромежностного доступа без предварительной колостомии (36 детей) и из заднесагиттального доступа с превентивно наложенной колостомой (113 пациентов). Сравнение показало, что все виды интра-и послеоперационных осложнений (ранение влагалища, ретракция прямой кишки после операции, рубцовый стеноз anusа, нагноение операционной раны), в основном, встретились у больных первой группы. В связи с этим пациентов с атрезией прямой кишки с ректовестибулярным свищом необходимо оперировать из заднесагиттального доступа по Peña с обязательным предварительным наложением колостомы. Ключевые слова: аноректальные пороки развития, девочки, хирургическое лечениеA two groups of patients with a rectovestibular fistulous rectal atresia, operated using anterior-perineal approach without a preliminary colostomy (36) and operated using a posterior-sagittal approach with a preventive colostomy (113) were subjected to a comparative analysis. The analysis revealed all types of postoperative complications (trauma of vagina, rectal postoperative retraction, anal scar stenosis, postoperative wound suppuration) mainly in the patients of the first group. In this regard, patients with rectal atresia with rectovestibular fistula must be operated on from Peña posterior sagittal access with mandatory prior colostomy.
The authors describe an extremely rare combination of omphalocele and isolated segments of the small intestine with enetercystomas having their own mesentery. This pathology was manifested by a syndrome of partial intestinal obstruction during 50 days after suturing the anterior abdominal wall because of omphalocele. During relaparotomy, a pair of separated intestinal fragments with hypertension in their inner content was removed. The patient recovered completely.
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