Purpose. A prospective study was carried out. It compared treatment outcomes in children who underwent esophagoplasty with stomach or colon esophagoplasty.Materials and methods. Clinical records of 172 patients who underwent esophagoplasty at N. F. Filatov Children’s Clinical Hospital No. 13 of Moscow from 2009 to 2015 were analyzed. The operated children were divided into two groups. 46 children from group 1 (basic group) aged 2 months to 13 years underwent esophagoplasty with stomach. 126 children aged 2 months to 18 years who had colon esophagoplasty were enrolled in group 2 (control group). In both groups, the majority was presented by children with atresia and corrosive strictures of esophagus. Clinical observation, esophagogastroduodenoscopy, contrast radiography, CT and MRI study, survey of patients were used to estimate direct and remote treatment outcomes.Results. The analyzed groups were comparable for the course of the early postoperative period. The early postoperative period had no complications in 54% of cases in group I and in 54.4% of cases in group II. Recurrent surgeries for complications were more frequent in group I (23.9%) as compared to group II until signifcant indices were reached (10.3%, p = 0.04). In the comparison groups, patients’ quality of life were signifcantly different by the rate of almost any complications in the remote period. They demonstrated better quality of life for children after colon esophagoplasty.Conclusion. Higher quality of life in children after colon esophagoplasty compared to children following esophagoplasty with stomach indicates that this is a surgery of choice in children.
Chronic pancreatitis is one of the most pressing problems of pediatric gastroenterology and surgery of hepatopancreatobiliary organs. Diagnosis and treatment of this category of patients requires a comprehensive examination using modern highly sensitive research methods and the collegial participation of a surgeon, gastroenterologist and endocrinologist. Due to the fact that the algorithm for managing these patients is not regulated, patients often receive enzyme replacement therapy for a long time, with indications for surgical treatment. In addition, the non-specificity of complaints and clinical manifestations of chronic pancreatitis, the asymptomatic course and the initial detection of exo- and endocrine insufficiency lead to a later choice of the optimal treatment method and increase the risk of complications. The key to effective care for children with chronic pancreatitis is the staging and continuity in research and treatment. At the Center for the Treatment of Developmental Anomalies and Diseases of the Hepatopancreatobiliary System in Children on the basis of the Filatov Hospital, highly effective interventions are carried out for chronic pancreatitis in children, the purpose of which is to ensure an adequate outflow of pancreatic juice using longitudinal pancreaticojejunostomy, which, in addition to draining the pancreas, allows to achieve clinical remission and stop the progression pathological process, including diabetes mellitus. The article reflects the experience of diagnosis and treatment of chronic pancreatitis in children.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.