Tactical approaches to surgical correction in postoperative complications in the anorectal zone in children

Abstract

Purpose. To improve the results of surgical correction of postoperative complications in children’s anorectal zone.
Materials and methods. 58 patients with IB in the anorectal zone during primary and repeated correction of anorectal malformations (ARM), who underwent 137 reconstructive operations, were examined. The diagnostic algorithm consisted of traditional complex methods of clinical, radiological, laboratory examination, including ultrasound, MRI and endoscopic methods of examination.
Results and concludians. The analysis of long-term results showed that unreliable primary diagnostics, lack of preoperative preparation, inadequate indications for the choice of surgery method led to the development of software for primary and repeated correction of ARM, which required a large number of repeated operations to treat. At the same time, the causes of the complication were studied, errors were analyzed, indications, terms, accesses, volume and efficiency of the primary operation were optimized, as well as failures leading to the necessity of repeated operations in children. Optimization of tactics, methods of surgical and rehabilitation treatment led to improvement of software results up to 85.6%.
The study was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. Informed consent of the parents of the children was obtained for the study.