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Pyrrhic disease is a congenital anomaly that occurs during embryogenesis due to the fixation of the splenic angle of the colon by a short and highly located left transverse-diaphragmatic ligament, creating a sharp bend and forming a "wellbore". In this case the passage of feces on a cross colon becomes difficult, there is also its sagging to a small pelvis. This pathology is characterized by paroxysmal pain (aggravated by exercise and after eating) and prolonged constipation, which progresses over time. Hilaiditis syndrome is a rather rare pathology in which there is an interposition of the hepatic angle of the colon between the liver and the diaphragm. There are permanent and intermittent localizations. The work generalizes the experience of evaluation of clinical manifestations and remote results of treatment of children with chronic colostasis caused by fixation abnormalities of the colon. 58 children were detected to have Payre’s disease, with Cyilaiditi’s syndrome – 3 children. 24 patients with Payre’s disease and 2 Cyilaiditi’s syndrome were operated on. To assess the effectiveness of surgery, children were divided into two groups: I group – comparative and II group - experienced. In I group (n=12 children) – the analysis of surgical treatment was performed traditionally. In II group (n=14 children) – the analysis of surgical treatment was conducted by means of the methods proposed. Traditional surgical treatment of Payre’s disease in children was followed by relapse of chronic constipation in 45,45%, pain in 50%, flatulence in 33,33% and failure of the ileocoecal closing apparatus in 100% of children. Unsatisfactory outcomes of surgical treatment of Cyilaiditi’s syndrome was observed in a child from the comparative group. Relapse of clinical symptoms to a lesser degree than before the surgery was found in 1 child from the experienced group. To treat Payre’s disease the following operation is proposed: intersection of the left diaphragm-colon ligament, resection of transverse colon and colofixation of the left bending of the colon. To treat Cyilaiditi’s syndrome (in case of dolichoascendocolon) the following operation is suggested: hepatopexy, resection of the right bending of the colon with ascending transversal anastomosis “end to end”, fixing of right bending of the colon. Their reasonability is being proved.

Introduction. Diseases that are accompanied by significant cutaneous-subcutaneous-fascial defects during surgery in children include: pilonidal cyst (PC), spinal hernia (SH), Fournier’s gangrene and wounds. Various methods of surgical treatment of PC consist of the stages: removal of the cyst and covering the wound surface with suturing or leaving the wound surface open. The existing methods of covering a defect in SH in children cannot satisfy surgeons, because they are accompanied by significant tissue tension, which causes complications. Fournier’s gangrene in children is a rare disease with a large area of soft tissue damage. Initial surgical debridement of wounds in childhood requires an individual approach with the choice of the correct method to close the defect. Purpose. To study the possibilities of using the rotation of vascularized cutaneous-subcutaneous-fascial flap (CSFF) for the surgical treatment of superficial defects in children. Materials and methods. The surgical treatment of superficial defects in 73 children in a City Children’s Hospital (Chernivtsi) with PC (29 children), SH (20 children), wounds of the face, limbs and trunk (23 children), Fournier gangrene (1 child) was analyzed. We compared the performing of traditional methods of treatment and rotational methods of using CSFF. Recovery time and postoperative complications were analyzed. Results. By using traditional methods of treating PC, complications were observed in 50%, when using the proposed plastic surgery with rotational CSFF in 6.67%; in case of SH – in 44.44% and 18.18%, with wounds – in 27.27% and 8.33%, respectively. Plastic reconstruction in Fournier’s gangrene recovered on the 40th day of the postoperative period. Conclusion. The use of cutaneous-subcutaneous-fascial rotational flap with perforating vessels surgery allows to reduce the amount of complications after operations for PC, SH, initial surgical debridement of wounds, Fournier’s gangrene. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies. Key words: cutaneous-subcutaneous-fascial flaps, superficial defects, children.

Introduction. Small intestine atresia is one of the most common causes of low bowel obstruction in newborns. Mortality in this pathology ranges from 5 to 60%, depending on the country. Modern views about surgical correction are rather contradictory. Purpose. To analyze the surgical treatment of small intestine atresia in the surgical department of the City Children’s Hospital No. 1 ССH) (Chernivtsi, Ukraine) and the surgical department Saint Damien Pediatric Hospital NPH (SDH) (Port-o-Prence, Haiti). To determine the best methods of surgery. Materials and methods. The surgical treatment of 15 children under the conditions of SDH (Haiti) and 12 children under conditions of the city children’s clinical hospital (CCH, Chernivtsi) with atresia of the small intestine was analyzed. Determined the effectiveness of closed (oblique «end-to-end» anastomosis, taping with «end-to-end» anastomosis, Denis-Brown and Louw anastomoses), discharging (U- and T-shaped, taping with anostomosing and suspended proximal enterostoma), anastomoses and stomas (end, double, according to Mikulich). Mortality with limited parenteral nutrition was 40% (SDH), with the presence of parenteral nutrition – 33.33% (ССH, Chernivtsi). Results. According to the analyzed data, we believe that the use of the method of surgical treatment should correspond to the type of atresia, the distance of the blind proximal end from the Treitz ligament, the difference in the diameters of the adducting and abducting sections, the possibility of parenteral nutrition, and the threat of short bowel syndrome (SCS). Conclusions. Y-shaped discharging anastomosis «side-to-side» with the removal of the proximal area in the form of a stoma, can be the method of choice in case of significant difference between the intestinal diameters. It provides a wide area of the small bowel junction, chyme abduction until the fistula heals, and can be used for different types of small bowel atresia. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies. Keywords: small intestine atresia, surgical treatment, children.

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