Endosurgical technologies in the treatment of children with intestinal obstruction

Abstract

Introduction. In recent years there has been an increase in the number of cases of postoperative adhesive intestinal obstruction among children after surgical interventions due to congenital anomalies of the gastrointestinal tract, traumatic injuries and abdominal masses. The laparoscopic technology opportunities are directly related to the type of obstruction and the severity of the patients’ condition on admission. The rationale for laparoscopic technologies will help improve the outcomes of surgical treatment of children with various types of intestinal obstruction.Aim. To evaluate the effectiveness of laparoscopic technologies in a group of children with intestinal obstruction.Materials and methods. The study included 88 patients who underwent surgery for intestinal obstruction from 2008 to 2022 at the age of 1 month up to 18 years (7.75 ± 4.62). The patients were divided into two groups: Group I – obstructive intestinal obstruction (51) and Group II – strangulating intestinal obstruction (37). Methods for personalized evaluation of the options for endosurgical interventions were created based on the coefficients of the Bayesian decision rule characteristics.Results and discussion. The method for personalized evaluation of the options for endosurgical intervention completion in the form of laparoscopic version was proposed on the basis of the analysis of clinical and anamnestic data, outcomes of instrumental approaches to preoperative diagnosis and laparoscopy in a group of patients with intestinal obstruction. Laparoscopic technology has proved to be effective in the groups of patients with obstructive and strangulation intestinal obstruction in 70 and 62.2% of follow-ups, respectively.Conclusion. The effectiveness of laparoscopic technologies in children with intestinal obstruction depends on the patients’ group-specific decision rule characteristics of the method for personalized evaluation of the options for endosurgical interventions and accounts for 66% (Sn – 90%; Se – 85%; ACC – 85.8%). The method for personalized evaluation of the options for endosurgical interventions is a highly informative test for a group of patients with intestinal obstruction (AUC – 92.2%).