Bekin A, Dyakonova E, Gusev A, Lokhmatov M, Potapov A, Sladkov D, Yatzik S, Fisenko A, Pereladova D. Experience in the surgical management of children with complicated crohn’s disease. J Clin Trials Exp Investig [Internet]. 2023 Oct. 15 [cited 2023 Oct. 30];2(4):229-38. Available from: https://jctei.com/index.php/jctei/article/view/73
Bekin A, Dyakonova E, Gusev A, Lokhmatov M, Potapov A, Sladkov D, Yatzik S, Fisenko A, Pereladova D. Experience in the surgical management of children with complicated crohn’s disease. J Clin Trials Exp Investig [Internet]. 2023 Oct. 15 [cited 2023 Oct. 30];2(4):229-38. Available from: https://jctei.com/index.php/jctei/article/view/73
Bekin A, Dyakonova E, Gusev A, Lokhmatov M, Potapov A, Sladkov D, Yatzik S, Fisenko A, Pereladova D. Experience in the surgical management of children with complicated crohn’s disease. J Clin Trials Exp Investig [Internet]. 2023 Oct. 15 [cited 2023 Oct. 30];2(4):229-38. Available from: https://jctei.com/index.php/jctei/article/view/73
Bekin A, Dyakonova E, Gusev A, Lokhmatov M, Potapov A, Sladkov D, Yatzik S, Fisenko A, Pereladova D. Experience in the surgical management of children with complicated crohn’s disease. J Clin Trials Exp Investig [Internet]. 2023 Oct. 15 [cited 2023 Oct. 30];2(4):229-38. Available from: https://jctei.com/index.php/jctei/article/view/73
Abstract
Crohn's disease (CD) is a chronic, immune-mediated inflammatory bowel disease characterized by transmural damage of various parts of the gastrointestinal tract. The aim of the study is to present our experience in pre-surgical diagnosis, selection of surgical tactics and volume of intervention in different variants of gastrointestinal tract lesions and disease activity.
We undertook cross-sectional, retrospective-prospective study of 64 children who underwent surgery due to complicated CD. We analyzed CD activity via PCDAI, medications used, inflam-mation localization, and changes in mass-growth parameters at pre-surgery stage.
Three patients from the group of 44 children with two-stage surgical treatment later showed inefficacy of GEBD in post-operative period. The disease progression was revealed and, therefore, subtotal colectomy was required. Three children had secondary adhesion of surgical wounds by means of active immunosuppressive therapy at preoperative period, and five patients developed suture sinuses at post-operative period. Early adhesive intestinal obstruction was revealed in 3 (4.7%) cases, and they required re-surgery.
Personalized approach to the surgical treatment of children with complicated CD has shown its efficacy due to the small percentage of postoperative complications with re-surgery. There was significant improvement in mass-growth parameters, recovery of albumin levels, and anemia decrease in 96.9% of cases in the long-term postoperative period (6 months or more). Two children (3.1%) had the narrowing of anastomotic zone lumen, thus, without any obstruction. These cases were associated with violations in drug treatment
Keywords
Crohn's disease in children; surgical treatment; laparoscopy; bowel stricture
Subject
Medicine and Pharmacology, Surgery
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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