We have reported the late results of ureteroplasties following gynecological operations in 91 patients. In all the 91 cases the ureteral defect was closed with a bladder flap by the Boari technique. In eleven cases the operation failed to be successful. Ten of these unsuccessful cases were patients with carcinoma. Analysis of the failures and the strict application of a modified surgical technique according to the procedure described by GIL-VERNET, with submucosal, displacement of the ureter as an antireflux protection, greatly improved our late results. On the basis of two case histories we have demonstrated the problem of postoperative radiotherapy in patients with carcinoma in whom ureteroplasty is necessary following intra- and post-operative ureteral lesions. Replacement of the distal ureter by a Boari flap over a length of more than 12 cm is possible in particular cases. Bilateral ureteral lesions, especially in patients with carcinoma, are operated most successfully by the transperitoneal approach. We also recommend the transperitoneal approach in patients who have undergone radiotherapy and in those with repeated Boari plasties.
Цель -изучить результаты лечения хронической дуоденальной непроходимости. Материал и методы. Представлен опыт лечения пяти детей с механической формой хронической дуоденальной непроходимости, из которых у двух имелся стеноз двенадцатиперстной кишки, у других детей причиной хронической дуоденальной недостаточности была артерио-мезентериальная компрессия. Результаты. Во всех наблюдениях удалось устранить дуоденальную непроходимость лапа-роскопическим способом, что позволило рано начать энтеральное питание и сократить сроки пребывания больных в отделении реанимации и в стационаре.
Ключевые слова: лапароскопия, хроническая дуоденальная непроходимость, артериомезентериальная компрессия, дети.Brief literature review devoted to chronic duodenal obstruction is presented in the article. We described an experience of treatment of 5 children with mechanical form of chronic duodenal obstruction. Duodenal stenosis was observed in 2 patients. Arteriomesenteric compression caused chronic duodenal obstruction in other children. Duodenal obstruction was cured using laparoscopy in all cases. Thus enteroalimentation has been started in early terms and intensive care unit stay and hospital stay was reduced.
VAC-therapy is safe and effective treatment of complicated wounds of anterior abdominal wall combined with intestinal and/or biliary fistulas in children.
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