Russian Journal of Pediatric Surgery, Anesthesia and Intensive CareRussian Journal of Pediatric Surgery, Anesthesia and Intensive CareРоссийский вестник детской хирургии, анестезиологии и реаниматологии2219-40612587-6554Eco-Vector154510.17816/psaic1545Original Study ArticlesОригинальные исследованияResearch ArticleСomplications and functional outcomes after restorative proctocolectomy with ileal pouch–anal anastomosis in children: A single-center experienceОсложнения и функциональные результаты после формирования тазовых тонкокишечных резервуаров у детей. Опыт одного центра儿童盆腔小肠贮液器形成后的并发症和功能结果。 单个中心的经验https://orcid.org/0000-0002-1515-06997241-8029KhabibullinaLinara R.ХабибуллинаЛинара РадиковнаKhabibullinaLinara R.
Russian Federation

Pediatric Surgeon of the Surgeon Department

врач – детский хирург

Pediatric Surgeon of the Surgeon Department

habibull.lin@yandex.ruhttps://orcid.org/0000-0002-9497-40703600-4701RazumovskyAlexander Yu.РазумовскийАлександр ЮрьевичRazumovskyAlexander Yu.
Russian Federation

MD, Dr. Sci. (Med.), Professor, Correspondent Member of Russian Academy of Sciences, Head of Pediatric Surgery Department, Pediatric Surgeon

д-р мед. наук, профессор, чл.-корр. РАН, заведующий кафедрой детской хирургии

MD, Dr. Sci. (Med.), Professor, Correspondent Member of Russian Academy of Sciences, Head of Pediatric Surgery Department, Pediatric Surgeon

1595105@mail.ruhttps://orcid.org/0000-0002-8514-30803478-8606ShсherbakovaOlga V.ЩербаковаОльга ВячеславовнаShсherbakovaOlga V.
Russian Federation

MD, Dr. Sci. (Med.), Head of Department of Pediactric Surgery, Pediatric Surgeon

д-р мед. наук, врач-детский хирург, колопроктолог, заведующая хирургическим отделением

Shcherbakova_o_v@rdkb.ruRussian Children’s Clinical HospitalРоссийская детская клиническая больница — филиал Российского национального исследовательского медицинского университета им. Н.И. ПироговаRussian Children’s Clinical HospitalPirogov Russian National Research Medical UniversityРоссийский национальный исследовательский медицинский университет им. Н.И. ПироговаPirogov Russian National Research Medical University14092023201020231333293390308202307092023Copyright ©; 2023, Eco-VectorCopyright ©; 2023, Эко-ВекторCopyright ©; 2023,2023Eco-VectorЭко-Векторhttps://creativecommons.org/licenses/by-nc-nd/4.0https://rps-journal.ru/jour/article/view/1545

BACKGROUND: Restorative proctocolectomy with ileal pouch–anal anastomosis is a prominent treatment for adult patients with ulcerative colitis and familial adenomatous polyposis, with satisfactory functional outcomes. In literature, that technique in pediatric practice is described; however, in the domestic literature, there is no mention of ileal pouch–anal anastomosis in children.

AIM: This study aimed to examine the outcomes of ileal pouch–anal anastomosis in pediatric patients.

MATERIALS AND METHODS: The study comprised 33 patients with an ileal pouch–anal anastomosis between January 2019 and June 2023. At the time of the ileal pouch–anal anastomosis, the average age was 13 (±5) yr. Patients were followed for an average of 17 (±14) months.

RESULTS: Patients with ulcerative colitis underwent three-stage surgical interventions more often than patients with another diagnosis (90% vs. 4%, p < 0.0001), and the mean duration of surgery in ulcerative colitis patients was shorter than in patients with polyposis syndromes or total agangliosis: 173 (±57) min versus 280 (±73) min. Late complications were reported in five (15%) patients undergoing ileal pouch–anal anastomosis. After the ileal pouch–anal anastomosis, analysis of patient questionnaires revealed that children had satisfactory functional results.

CONCLUSIONS: Several encouraging studies have confirmed good functional outcomes after ileal pouch–anal anastomosis. Our findings suggest that ileal pouch–anal anastomosis in children is associated with favorable results.

Актуальность. Колопроктэктомия с формированием тазового тонкокишечного резервуара занимает лидирующую позицию при лечении взрослых пациентов с язвенным колитом и аденоматозным полипозным синдромом и имеет удовлетворительные функциональные результаты. В зарубежной литературе описано применение указанной методики и в педиатрической практике, однако в отечественной литературе упоминание о формировании тазовых тонкокишечных резервуаров у детей отсутствует.

Цель — анализ собственных результатов формирования тонкокишечных резервуаров у пациентов детского возраста.

Материалы и методы. В ретроспективное исследование включено 33 пациента, которым в период с января 2019 г. по июнь 2023 г. проведено формирование тазового тонкокишечного резервуара. Средний возраст пациентов на момент формирования тонкокишечного резервуара составил 13 (±5) лет. Медиана наблюдения за пациентами — 17 ± 14 мес.

Результаты. Пациентам с язвенным колитом чаще, чем пациентам с другими диагнозами проводились 3-этапные оперативные вмешательства (90 % против 4 %, р < 0,0001), в связи с этим среднее время формирования тазового тонкокишечного резервуара у пациентов с язвенным колитом короче, чем у пациентов с полипозными синдромами или тотальным аганглиозом — 173 (±57) мин против 280 (±73) мин. Из 33 пациентов с тонкокишечным резервуаром поздние осложнения зарегистрированы у 5 (15 %) пациентов. Анализ анкет пациентов показал, что дети в нашем исследовании имеют удовлетворительные функциональные результаты после проведенной операции.

Заключение. Мы обладаем достаточным количеством обнадеживающих исследований, подтверждающих хорошие функциональные исходы после формирования тазового тонкокишечного резервуара, в том числе и у детей. Наше исследование показало, что формирование тонкокишечного резервуара у детей в нашей клинике сопряжено с удовлетворительными результатами.

论证。在溃疡性结肠炎和腺瘤性息肉病综合征成人患者的治疗中，结肠肛门切除术伴有盆腔小肠贮液器的形成占据主导地位，并取得令人满意的功能效果。国外文献也介绍这种技术在儿科临床中的应用。然而，国内文献中并未提及儿童盆腔小肠贮液器的形成。

该研究的目的是对我们自己在儿科患者小肠贮液器形成方面取得的成果进行分析。

材料与方法。本回顾性研究共纳入了33名患者。这些患者在2019年1月至2023年6月期间接受了盆腔小肠贮液器成形术。小肠贮液器形成时患者的中位年龄为13（±5）岁。患者的中位随访时间为17±14个月。

结果。与其他诊断的患者相比，溃疡性结肠炎患者更有可能接受三阶段手术干预（4%对90%， p < 0.0001）。因此，与息肉病综合征或先天性巨结肠症患者相比，对于溃疡性结肠炎患者来说， 盆腔小肠贮液器形成的平均时间更低（280（±73）分钟对173（±57）分钟）。在33名小肠贮液器患者中，有5名（15%）患者出现了晚期并发症。对患者问卷的分析表明了，本研究中的患儿术后功能效果令人满意。

结论。我们有大量令人鼓舞的研究。这些研究证实，盆腔小肠贮液器成形术后的功能效果良好（包括儿童在内）。我们的研究表明了，在我们的诊所中，为儿童形成小肠贮液器的效果令人满意。

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