Elective laparoscopic bowel resections in children with Crohn's disease
Authors:   A.I.Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russian Federation, Poddubny I.V. ,   The Federall Scientific and Clinical Center for Children and Adolescents of the Federal Medical and Biological Agency of Russia, Moscow, Russian Federation,   Morozov Children's City Clinical Hospital of the Moscow Healthcare Department, Moscow, Russian Federation, Alieva E.I. ,   The Federall Scientific and Clinical Center for Children and Adolescents of the Federal Medical and Biological Agency of Russia, Moscow, Russian Federation, Sytkov V.V. ,   A.I.Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russian Federation,   The Federall Scientific and Clinical Center for Children and Adolescents of the Federal Medical and Biological Agency of Russia, Moscow, Russian Federation, Malashenko A.S. ,   The Federall Scientific and Clinical Center for Children and Adolescents of the Federal Medical and Biological Agency of Russia, Moscow, Russian Federation, Kozlov M.Yu. ,   Morozov Children's City Clinical Hospital of the Moscow Healthcare Department, Moscow, Russian Federation, Shcherbakova O.V. ,   Morozov Children's City Clinical Hospital of the Moscow Healthcare Department, Moscow, Russian Federation, Nikitin A.V. ,   Morozov Children's City Clinical Hospital of the Moscow Healthcare Department, Moscow, Russian Federation,   Pirogov Russian National Research Medical University (Pirogov Medical University), Moscow, Russian Federation, Yablokova Ye.A. ,   Research Clinical Institute of Childhood, Ministry of Health of the Moscow Region, Mytishchi, Russian Federation, Erokhina M.I. ,   Research Clinical Institute of Childhood, Ministry of Health of the Moscow Region, Mytishchi, Russian Federation, Severinov D.A. ,   Kursk State Medical University, Kursk, Russian Federation
Published: December 2023

Currently, laparoscopic operations are widely used in pediatric surgical practice (both emergency and elective surgery). Separately, it is worth noting the difficulty of performing reconstructive surgical interventions using endovideosurgical technologies in pediatric coloproctology and surgery of inflammatory bowel diseases (Crohn's disease, ulcerative colitis, etc.). Objective. Present the experience of performing laparoscopic reconstructive surgical interventions in pediatric patients with Crohn's disease. Patients and methods. For the period from 2005 to 2023, 64 children with various forms of Crohn's disease on the basis of the FNCC of children and adolescents of the FMBA of Russia (Moscow), Morozovskaya DGKB (Moscow) underwent planned reconstructive laparoscopic interventions: ileocecal resection, resection of the small and large intestine with equipment side-to-side anastomosis, rectal resection with manual low colorectal anastomosis, subtotal colectomy. Results. The average surgery time was 150 minutes. In the postoperative period, complications developed in 6 children (9.4%). The duration of postoperative hospitalization averaged 7 days. In 6 cases, postoperative complications were noted, in 4 cases (inflammatory changes from the umbilical wound and the formation of the intestinal fistula here) it was possible to resolve them conservatively through antibacterial therapy and local treatment. But in the 2 remaining cases, repeated interventions were required due to the failure of the hardware suture and the formed stricture in the anastomosis zone. Conclusion. Treatment of children with complicated forms of Crohn's disease should be carried out in specialized centers with the participation of a multidisciplinary team of specialists at all stages of treatment. With the correct selection of patients and the timing of surgery, the laparoscopic technique allows efficient and safe resection and restoration of intestinal continuity at any location and length of strictures. Key words: Crohn's disease, inflammatory bowel disease, apparatus anastomosis, children, laparoscopy, laparoscopic resection