Repeated reconstructive surgeries for postoperative complications of anorectal malformations in children

Abstract

The causes of postoperative complications in the correction of anorectal malformation were studied according to follow-up, general clinical and additional research method in 65 operated sick children. In the process of diagnosis and surgical correction, a number of diagnostics, tactical, and combined errors and shortcomings were identified that caused postoperative complications, which required a large number of repeated reconstructive operations. The authors recommend various options for tactical and operational-technical treatment approaches when solving the problems of repeated reconstructive operations. At the same time, it is proposed to study the causes, analyze errors, complications and failures, indications, terms, accesses, the volume of the operation and evaluate their effectiveness. The authors, thanks to the optimization of tactics, method of surgical and rehabilitation treatment, were able to improve the results of postoperative complications to 81.4%. In the course of the study of catamnestic and examination data 65 of children with postoperative non-NAS in the process of diagnosis and surgical correction errors and deficiencies were revealed as: unreliable primary diagnosis, insufficiency of preoperative preparation, inadequate indication and choice of the method of operation, inadequate postoperative rehabilitation. All these had diagnostic, tactical, technical and combined character, which led to the formation of the postoperative HCA, which required a large number of repeated operations. Therefore, the authors suggest that to solve the problems of repeated operations is not limited to the improvement of surgical techniques, and to study the causes, analysis of errors, complications and failures that lead to repeated interventions, indications, timing, access, scope of surgery and their evaluation of effectiveness, medical and social rehabilitation of patients. The authors, thanks to the optimisation of tactics, method of surgical and rehabilitation treatment, managed to correct the post-surgical NAC up to 80,4%.