scholarly journals Errors and сomplications in the treatment of children with anorectal malformations

2021 ◽  
Vol 10 (2) ◽  
pp. 125-136
Author(s):  
Evgeniya S. Pimenova ◽  
Darya S. Tarasova ◽  
Dmitry D. Morozov ◽  
Dmitry A. Morozov
Keyword(s):  
Surgical Treatment ◽  
Historical Analysis ◽  
Diagnostic Errors ◽  
Anorectal Malformations ◽  
Fecal Impaction ◽  
Urogenital Sinus ◽  
Patients Âgés ◽  
Emergency Procedures ◽  
Sex Development ◽  
Prolonged Delay

Purpose. This manuscript aims to introduce errors and complications of diagnosis and treatment in children with anorectal malformations (ARM). Methods. A retrospective analysis of 63 children with ARM treated at a single tertiary Speransky childrens Hospital. Results. The patients ages ranged from 2 mo to 17 y. o. (median, 6 y. o.). The types of ARM included: rectourethral fistula 27%, rectoperineal fistula 17.5%, rectovestibular fistula 15.9%, rectobladderneck fistula 6.3%, no fistula 7.9%, cloaca 11.1%, cloaca with urogenital sinus and disorder of sex development 1.6%, pouch colon 1.6%, rectal stenosis 4.8%, anal duplication 3.2%, and rectovaginal fistula 3.2%. Of these patients, 76% underwent surgery earlier at another hospital (surgical treatment completed), 14% had stomas, and 10% did not have any prior procedures. The historical analysis showed diagnostic errors in 48% of children (untimely diagnosis, incorrect interpretation of the ARM variant, prolonged delay in anorectoplasty). Errors led to emergency procedures or changes in subsequent surgical treatment (further ostomy, excess bowel resection) in 22% of cases. After anorectoplasty (stenosis, mislocated anus/rectum, rectal prolapse), complications were detected in 56% of cases, whereas ostomy complications were observed in 5% of cases. Long-term problems after the surgical treatment (constipation, incontinence, and pseudoincontinence) were evident in 98% of children. Different surgical reconstructive techniques of the sphincter formation had been performed previously in 13% of patients. Moreover, they most often had spinal pathology as the cause of functional disorders. Only half of the childrens parents had information about bowel management, 38% did not follow the recommendations and usually had fecal impaction and pseudoincontinence. 45% of children/parents performed non-effective or irregular enemas and required corrective treatment. Conclusion. It is recommended that Russian pediatric surgeons treat children with ARM, according to Russian pediatric surgeons guidelines consistent with international protocols to avoid errors and complications.

Anus perinei ventralis in adulthood – case report

2020 ◽  
Vol 99 (12) ◽  
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Congenital Malformations ◽  
Anorectal Malformations ◽  
Intermediate Type ◽  
Perineal Fistula ◽  
Sphincter Complex ◽  
Golden Standard ◽  
Anorectal Reconstruction ◽  
Anorectal Atresia

Anorectal malformations present a type of the most serious congenital malformations, either in terms of treatment or treatment outcomes. Anorectal atresia can be subdivided into three categories: the supralevator form, the intermediate type of atresia and the low translevator type. One of the clinical forms of low translevator type in girls is a perineal fistula opening just behind the vaginal entrance on the perineum, with a fully developed sphincter complex dorsally from the fistula (so called anus perinei ventralis). The golden standard of surgical treatment of anus perinei ventralis in children is Peña’s procedure, which was used as a guideline for anorectal reconstruction in our adult patient, as well.

Prevalence of Early Post-Operative Complications in Patients Undergoing Surgical Treatment for Meningomyelocele

2021 ◽  
Vol 15 (9) ◽  
pp. 2770-2772
Author(s):  
Muhammad Pervez Khan ◽  
Naeem ul Haq
Keyword(s):  
Surgical Treatment ◽  
Descriptive Study ◽  
Defect Size ◽  
Accurate Diagnosis ◽  
Cerebrospinal Fluid Leakage ◽  
Patients Âgés ◽  
Early Postoperative Complications ◽  
Operative Complications ◽  
Complications Rate ◽  
Post Operative Complications

Objective: To determine the prevalence of early postoperative complications in patients undergoing surgical treatment for meningomyelocele. Study Design: Descriptive study Place & Duration: Department of Neurosurgery, Saidu Teaching Hospital, Saidu Sharif, Swat for duration of three years from November 2017 to October 2020. Methods: Total one hundred and thirty six patients of both genders presented with meningomycele were included in this study. Patients’ ages were ranging from 5 to 120 days. All the patients were undergoing surgical treatment for meningomyelocele. Early post-operative complications were recorded after surgery Results: There were 76 (55.88%) males and 60 (44.12%) females. Forty (29.41%) patients were ages <1 month, 59 (43.38%) patients were ages 1 to 2 months 37 (27.21%) were ages above 2 months. Majority of patients 70 (51.47%) had defect size <5 cm. Post-operative complications such as surgical site infection, pyrexia, hydrocephalus and cerebrospinal fluid leakage in 20 (14.71%), 115 (84.56%, 29 (21.32%) and 33 (24.26%) patients respectively. Conclusion: Early and accurate diagnosis and better management may reduce the complications rate Keywords: Prevalence, Complications, Meningomvelocele

Surgical treatment of anorectal malformations

Surgery Today ◽  
2012 ◽  
Vol 43 (9) ◽  
pp. 955-962 ◽  
Author(s):  
Naomi Iwai ◽  
Shigehisa Fumino
Keyword(s):  
Surgical Treatment ◽  
Anorectal Malformations

Preliminary Analysis of the Surgical Treatment of Anorectal Malformations in Russia

2014 ◽  
Vol 25 (06) ◽  
pp. 537-540
Author(s):  
Evgeniya Pimenova ◽  
Evgeniy Oculov ◽  
Alexey Gusev ◽  
Kseniya Utkina ◽  
Dmitry Morozov
Keyword(s):  
Surgical Treatment ◽  
Preliminary Analysis ◽  
Anorectal Malformations

scholarly journals Relevant problems of classification of anorectal malformations in children in modern conditions (literature review)

2020 ◽  
pp. 41-48
Author(s):  
O. Dzham ◽  
◽  
O. Sliepov ◽  
Keyword(s):  
Surgical Treatment ◽  
Anorectal Malformations ◽  
Great Difficulty ◽  
The Third ◽  
Common Criteria ◽  
The World ◽  
Pouch Colon ◽  
Methodological Approaches ◽  
Second World

Given the diversity of anatomical and functional manifestations of congenital anorectal malformations, the most relevant remains development of classification of this pathology, for the same understanding by doctors of the manifestations of this defect and developing optimal common criteria for treatment tactics and strategies. The paper presents historical and current information on the classification of anorectal malformations in children. The main contradictory issues of the existing classifications are identified. The relevance of the use of Krickenbeck classification in the treatment of these defects is highlighted. Under the influence of different colorectal schools, historically, different educational and methodological approaches to the treatment of anorectal malformations. The first International Congress of Pediatric Surgeons was held in Melbourne, Australia, in 1970. The Melbourne meeting established an international classification of anorectal malformations. It was based on the development of defects at the stages of embryogenesis and their division by sex. Also, they are divided into: low, intermediate and high anorectal malformations. The second World Meeting of Pediatric Surgeons was held in Wingspread, Wisconsin, USA, in 1984, when F. D. Stephens and E. Smith, with a group of experts from around the world, proposed a detailed PAHR classification. The advantage of the Wingspread classification was that it could be used to predict the most optimal surgical treatment for various variants of anorectal defects. The third international conference on the development of standards for the treatment of congenital anorectal malformations took place in Krickenbeck, Germany, in 2005. This conference radically changed the latter classification, removing the terms «low», «intermediate» and «high» and the differences between female and male anomalies. The assessment depended on the presence and type of fistula. The reason for adopting such a classification was the great difficulty in comparing the results of different operations according to the old Wingspread classification. The peculiarity of this classification is the great contribution of colleagues from the Indian and Asian subcontinents to the surgical treatment of several anomalies, in particular: Pouch colon, which are rare in other countries. Today, pediatric surgeons in Ukraine generally do not use the Krickenbeck classification, despite the fact that it is generally accepted in most countries. This leads to the application of different approaches to the surgical treatment of congenital anorectal malformations, which emphasizes the relevance of further study of this issue. The informed consent of the patient was obtained for conducting the studies. Key words: congenital anorectal malformation, classification, children.

scholarly journals PREVALENCE OF EARLY CERVICAL OSTEOCHONDROSIS RISK ASSESSMENT SCALE OF THE NEUROLOGICAL COMPLICATIONS OF SURGICAL TREATMENT IN PATIENTS WITH THE POST-TRAUMATIC DEFORMATIONS OF THE THORACIC AND LUMBAR SPINE

2019 ◽  
Vol 26 (1) ◽  
pp. 45-57
Author(s):  
Asker A. Afaunov ◽  
Aleksandr V. Kuz’menko ◽  
Igor’ V. Basankin ◽  
Mikhail Yu. Ageev
Keyword(s):  
Risk Assessment ◽  
Surgical Treatment ◽  
Lumbar Spine ◽  
Conflict Of Interest ◽  
Rapid Assessment ◽  
Diagnostic Errors ◽  
Neurological Complications ◽  
Factors Affecting ◽  
Thoracic And Lumbar Spine ◽  
Post Traumatic

The aimis to develop and propose a scale for assessing the risk of neurological complications as a result of surgical treatment in patients with the post-traumatic deformations of the thoracic and lumbar spine.Materials and methods.An analysis of the treatment of 124 patients (70 men and 54 women) aged 18–54 with post-traumatic deformations of the thoracic and lumbar spine was carried out. The patients were operated during the 2003–2017 period. Repeated surgeries were performed after the period from 6 months to 14 years after injury. In 63 cases, spinal deformation was the result of unsuccessful surgical treatment, while 61 cases were due to diagnostic errors and/or inadequate conservative treatment.Results.The analysis of the clinical data identified factors affecting the manifestation of neurological complications, as well as 46 assessment options for risk gradation.Conclusion.The proposed scale can be used for a rapid assessment of the risk of neurological complications of surgical treatment of patients with the post-traumatic deformations of the thoracic and lumbar spine.'Conflict of interest: the authors declare no conflict of interest.

scholarly journals A method of reconstruction of female genitalia in girls with virilization

2014 ◽  
Vol 95 (3) ◽  
pp. 450-454 ◽  
Author(s):  
N R Akramov ◽  
A K Zakirov
Keyword(s):  
Surgical Treatment ◽  
Ambiguous Genitalia ◽  
Term Treatment ◽  
Urogenital Sinus ◽  
Basic Knowledge ◽  
Treatment Quality ◽  
Step Method ◽  
Self Identity ◽  
Long Term Treatment ◽  
One Step

The most common cause for female virilization is congenital adrenal hyperplasia. For anticipating the serious psychological distress related to ambiguous genitalia, these patients require plastic surgery. At present, two-step methods are preferred as more reliable. However, the surgical treatment in this case extends over several years, and can greatly affect patient’s psychosocial status. Based on the analysis of known surgical treatments, we proposed a one-step method of feminizing genitoplasty. The advantages of the proposed method allows one-step surgical treatment of girls with virilized genitalia at an earlier age, before the child reaches the period of sexual self-identity. This approach provides less psychosocial distress and reduces the number of interventions, maintaining the adequate sensitivity of the clitoris, providing moist and age-appropriate vaginal opening by using the preputium of the penis homolog and urogenital sinus mucosa at genitoplasty. The abovementioned advantages increases the surgical treatment quality and quality of life in girls with virilized genitalia. The method is reproducible by pediatric surgeons with basic knowledge of children’s anatomy. Yet, a lengthy follow-up is needed to assess the long-term treatment results.

scholarly journals Clinical manifestations, diagnosis, and surgical treatment of compressive common peroneal neuropathy at the level of the fibular head

2021 ◽  
Vol 13 (1) ◽  
pp. 18-23
Author(s):  
M. G. Bashlachev ◽  
G. Yu. Evzikov ◽  
V. A. Parfenov
Keyword(s):  
Surgical Treatment ◽  
Peroneal Nerve ◽  
Clinical Manifestations ◽  
Diagnostic Errors ◽  
Common Peroneal Nerve ◽  
Complete Recovery ◽  
Diagnosis And Treatment ◽  
Partial Recovery ◽  
Nerve Decompression ◽  
Peroneal Neuropathy

Common peroneal neuropathy (CPN) is the most common tunnel neuropathy in the lower extremities, many issues of diagnosis and treatment of which require further study.Objective: to analyze the clinical manifestations of CPN, methods of its diagnosis and treatment results.Patients and methods. Eighty patients (31 women and 49 men) aged 18 to 82 years (mean age, 51 years) with compressive CPN were followed up during 2012–2018. Unilateral CPN and bilateral CPN were found in 76 and 4 patients, respectively. Eighty-four common peroneal nerve decompression operations were performed.Results and discussion. There was paralytic CPN in 73 (87%) surgical cases, painful CPN in 8 (9.5%), and intermittent CPN in 3 (3.5%). Diagnostic errors (when CPN was regarded as discogenic radiculopathy or lumbar stenosis) were noted in the painful and intermittent forms of the disease. After surgical treatment, complete recovery of peroneal nerve function was observed in 61 (72.6%) of the 84 surgical cases; its partial recovery in 15 (17.9%). Positive results were seen in all cases of painful and intermittent CPN, whereas they were more often observed in paralytic CPN if the operation was performed early (up to 12 months) after the onset of the disease.Conclusion. Common peroneal nerve decompression is an effective and safe therapeutic method that, in painful and intermittent CPN, leads to complete reversal of symptoms and, in the paralytic form of the disease, it is most effective in the early stages of the disease.

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