Payr’s disease in children: disorder of local immunity and surgical treatment

Abstract

Objective. To study the status of the immunity indicators and to improve the surgical treatment outcomes of Payr’s disease (PD) in children.
Material and methods. The experience of surgical treatment of 24 children with PD, representing 12% from all examined patients with this disease (200 patients) is presented. Patients were divided into two groups. The I group (11 children) was comparison group. The II primary group comprised 13 children who underwent the proposed surgical method of treatment. The latter included resection of excess part of colon along with colofixation. The secretory immunoglobulin A concentration (sIg A) and lysozyme levels in coprofiltrates were investigated. The surgical intervention efficacy had been evaluated during 1 to 12 years follow-up after the surgery.
Results and discussion. The sIg A concentration in the II group during the postoperative period compared to the preoperative one was 12.12% higher and in the I group it made up only 2.51% higher respectively. The lysozyme level increased in both groups in the postoperative period. Surgical treatment of PD in the I group of children was complicated by the chronic constipation recurrence in 45.45% of cases and the pain syndrome in 50% of patients, in the II group – in 7.69% and 9.09% of cases respectively.
Conclusion. Correction of the chronic colostasis embryological reason (ligaments correction) and its consequences (the resection of extended part of colon along with the left flexure of colon) in combination with colon fixation helps to improve the surgical treatment outcomes of PD in children and increases the level of local immunity.