Rehabilitation of Children with Anorectal Malformations
Journal Title: Progressing Aspects in Pediatrics and Neonatology - Year 2018, Vol 1, Issue 3
Abstract
Rehabilitation of patients after anoplastic surgery is the most complex and poorly studied problem in the surgery of anorectal malformations. The process of rehabilitation should begin from the moment of diagnosis. Already in the earliest period, the question should be decided at what age a radical operation will be carried out. The second problem is always to determine the size of the outer opening of the ectopic anal canal. If the available opening is not sufficient for normal bowel evacuation, which is accompanied by signs of intestinal obstruction, this child should be given a colostomy, with which the patient will live until the moment of the radical surgery. In those cases where the external aperture of the ectopic anal canal allows unobstructed evacuation of the intestine before the radical surgery is performed, the colostomy should be applied as the first stage of multi-stage surgery. According to the literature, after surgical correction of the studied pathology in girls 40-60% of children suffer from incontinence of intestinal contents of various degrees, 27-38% of children suffer from constipation (K. U. Ashcraft, T. M. Holder 1990, K. N. Salamov, U. V. Dultsev, 1998, A. I. Lenyushkin 2003, A. Pena 1988, A. M. Holschneider 1994, V. Aftimas 2001) [1]. According to most researchers, a good outcome, as well as a reduction in the number of complications, depends not only on the choice of surgical intervention method, but also on rehabilitation measures (A. I. Lenyushkin 1999, A. Pena 1993). Stool incontinence after surgical treatment of anorectal malformations is the most serious complication in the social aspect. The factors that lead to violation of the control of defecation are congenital and acquired during the operation, violations of the anatomical structure of the pelvic floor muscles and the external sphincter, as well as a violation of the sensitivity and proprioceptivity of the lowered intestine (F.D. Stephens and E.D. Smith, J.J. Templeton and J.A. Diteshim 1985). Rehabilitation of children with low anorectal malformation should take place during all stages of their examination and surgical treatment. The operation in turn is only a stage in the complex treatment of children with malformations of the anorectal region [2]. The right choice and perfect execution, the absence of postoperative complications, will undoubtedly contribute to the obtaining of good functional results, but the final result will be determined to a greater extent by the quality of rehabilitation measures in the near and distant postoperative period.
Authors and Affiliations
TT Narbayev, U Kh Tilavov, NN Turaeva, BA Terebaev, FO Sobirova, JF Arifdjanova, ND Yuldasheva, MM Nasirov
Keywords
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- EP ID EP576396
- DOI 10.32474/PAPN.2018.01.000113
- Views 61
- Downloads 0
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