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TÜRKÇE
Poster - 322
Features of intestinal stomas in children with Crohn's disease
Olga Shcherbakovа 1, Elmira Alieva 2, Saidkhasan Bataev 3, Ilya Zyabkin 4, Lenara Khabibullina 5, Oksana Bychkova 1
1 Federal Scientific and Clinical Center for Children and Adolescents of the FMBA of Russia
2 Federal Scientific and Clinical Center for Children and Adolescents of the FMBA of Russia, Burnazyan Scientific Research Center of the FMBA of Russia
3 Federal Scientific and Clinical Center for Children and Adolescents of the FMBA of Russia, Burnazyan Scientific Research Center, Pirogov Russian National Research Medical University. Kh. Ibragimov Complex Institute of the Russian Academy of Sciences
4 Federal Scientific and Clinical Center for Children and Adolescents of the FMBA of Russia, Burnazyan Scientific Research Center
5 Federal Scientific and Clinical Center for Children and Adolescents of the FMBA of Russia, Pirogov Russian National Research Medical University. Moscow, Russia.
Introduction.
Crohn's disease (CD) in children is often represented by more severe forms than in adults. The aim of the work was to analyze the results of treatment of children with CD an intestinal stoma in different forms of the disease.
Methods. A retrospective study was conducted analyzing the results of treatment of 164 children with complicated CD. Patients underwent resection of a section of the intestine with the imposition of a primary anastomosis without a stoma or with the imposition of a preventive stoma, or a stoma was formed in the resection area, or a diverting stoma was created without bowel resection.
Results. In patients with stricturing CD (n=74), bowel resections were performed with the formation of a stoma in the resection area (13%), creation of an anastomosis with the imposition of a proximal preventive stoma (6%), and stoma removal without bowel resection (9.7%). Most patients subsequently managed to close the stoma (96%). In the group of penetrating CD with strictures (n=46), resections of the intestinal section were performed with the imposition of anastomosis without a stoma (63%) or with the creation of a preventive stoma (17%), or ostomy was performed without intestinal resection (20%).
In children with CD of the colon, ileostomy was formed in 80% of cases. In patients with pararectal fistulas and active proctitis - in 48%.
The average follow-up period was 3 years. An unfavorable prognosis of CD was revealed in cases of stoma formation in severe paraproctitis (p=0.0002) and in severe refractory colitis with perianal lesions (p=0.0075).
Conclusion: Indications for a preventive intestinal stoma are high inflammatory activity in patients with CD who have not previously received treatment or when therapy is ineffective. The formation of a diverting stoma is necessary for complex pararectal fistulas, with severe proctitis and widespread damage to the pararectal tissue.