Pediatric Surgery

doi: 10.25005/2074-0581-2017-19-3-313-319
TREATMENT OF PERISTOMAL COMPLICATIONS IN CHILDREN WITH EXTERNAL ARTIFICIAL SMALL INTESTINE FISTULAS

Sh.R. Sultonov, H.K. Pulatov, I.B. Shernazarov, Sh.J. Rakhmonov, Yu.T. Dododzhonov, I.K. Atoev, H.J. Guriev

Department of Pediatric Surgery, Avicenna Tajik State Medical University, Dushanbe, Tajikistan

Objective: To improve the results of treatment of peristomal complications (PC) in children.

Methods: The results of treatment of 120 patients with artificial external intestinal fistulas of various etiologies at the age from 1 year to 15 years are studied. PC was noted in 26 patients, which was 21.7%. The most frequent PC were: intestinal eventration, stomal prolapse, retraction of the stoma, intestinal necrosis, stenosis of the stoma, inflammatory changes in the skin of the peristomal region, irritation and maceration of the skin around the fistula, etc.

Results: With each type of PC, the treatment tactic was individual. Surgical correction of the PC was carried out by 8 patients out of 21. Two patients underwent dissection of the stoma with stenoses. Reconstructions of the stoma were performed in 6 cases: 2 patients with necrosis of the stoma, 2 – in connection with the retraction of the stoma and 2 – the reconstruction was performed in connection with the intestinal eventration. The remaining 13 patients of PC were corrected by conservative methods with the use of modern means of care for intestinal fistulas.

Conclusions: Timely diagnosis and correction of the PC in children with external artificial small intestinal fistulas positively affected the further fate of the child and the results of a radical operation of the underlying disease. Multi-stage correction of pathology and inflammatory diseases of the gastrointestinal are the cause of long-term rehabilitation, large financial expenses. One of the most important tasks of this problem is undoubtedly the provision of qualified medical care to the children who carry the stoma and the education of the parents, as well as the patients themselves, to care for the intestinal stoma. These measures, undoubtedly, will allow avoiding a number of various peristomal complications, tactical and technical mistakes.

Keywords: Stoma, intestinal fistula, peristomal complications, treatment.

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Authors informations:

Sultonov Sherali Rahmonovich, Doctor of Medical Sciences, Head of the Department of Pediatric Surgery, Avicenna TSMU

Pulatov Kholbozor Kakulovich, Competitor of the Department of Pediatric Surgery, Avicenna TSMU

Shernazarov Ibragim Begmirzaevich, Candidate of Medical Sciences, Assistant of the Department of Pediatric Surgery, Avicenna TSMU

Rahmonov Shokhin Jalolovich, Candidate of Medical Sciences, Assistant of the Department of Pediatric Surgery, Avicenna TSMU

Dododzhonov Yuldoshboy Tukhtaboevich, Assistant of the Department of Pediatric Surgery, Avicenna TSMU

Atoev Ilkhom Kamolovich, Candidate of Medical Sciences, Assistant of the Department of Pediatric Surgery, Avicenna TSMU

Guriev Kholid Jomahmadovich, Laboratory Assistant of the Department of Pediatric Surgery, Avicenna TSMU

Address for correspondence:

Sultonov Sherali Rahmonovich

Doctor of Medical Sciences, Head of the Department of Pediatric Surgery, Avicenna TSMU

734003, Republic of Tajikistan, Dushanbe, Rudaki Ave., 139

Tel.: (+992) 918 629817

E-mail: sherali_1969@mail.ru

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