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The efficacy of preparation "Tachocomb" application in 224 children, ageing from 1 day to 18 years old, was studied up. The spectrum of the preparation studying had included the investigation of its properties, which secure an additional isolation for the intestinal and vascular walls defects, and hemostatic effect in the hemorrhage area as well. The data obtained trust the safety and efficacy of "Tachocomb" platelets application in pediatric surgery and permit to recommend them for improvement of the surgical treatment results.

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In 12 children with the different forms of anorectal atresia, for studying the state of a sphincter apparatus of the rectum and assessment of quality of its bringing down into the perineum after proctoplasty, computerized tomography of the organs of a small pelvis was used. Underdeveloped and undifferentiated musculus levator ani in children with high anorectal atresia and fistula to the urinary bladder was revealed. The method permits to establish exact location of the intestine brought down relative to musculus levator ani and external anal sphincter.

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In the pathogenesis of aneurysm of the internal jugular vein, the loss of its capacity function hampering blood outflow from the cranial cavity is of leading importance. Disorders in cerebral hemodynamics registered in rheoencephalography were revealed in all the patients examined. In 40% of them, the signs of venous encephalopathy were noted. Thus, presence of an aneurysm is an indication for operative intervention. The operation under the conditions of growing organism together with elimination of aneurysm is aimed at restoration of capacity function of the internal jugular vein and ensuring of its growth. Circular resection of aneurysm with end-to-end suturing of the vein and extravasal plasty with the use of polyurethane perforated tubular protector cut in a screw-shaped manner is an adequate operation.

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A method for creation of an artificial bladder from the rectum, which was used in 22 children with exstrophy of the bladder with good anatomic and functional results is suggested. In clinical and histologic studies, the inferiority of the exstrophied bladder tissues and unexpediency of their use for plasty have been proved. A long-term result of treatment in 31 of the 35 patients operated on with the use of different methods was studied by the data of complex evaluation of the functions of an artificial bladder, upper urinary tracts and rectal sphincter apparatus.

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Experience with the treatment of 70 children with anorectal atresia with a fistula into the urinary tracts is summarized. Comparative analysis of the effectiveness of the different methods of peritoneo-perineal proctoplasty was carried out. The methods for formation of the artificial smooth muscle sphincter of the intestine brought down and anoplasty are suggested. Introduction of these methods permitted to decrease the incidence of postoperative complications and improve a functional result of the operations. The methods for performance of a repeated operation after failed primary correction of a defect are presented. The importance of postoperative rehabilitation of the patients is noted.

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The authors observed 25 children at the age of from 2 mos to 14 years with the different forms of gastric and intestinal duplication. Cystic forms of duplication (16 cases) were manifested mainly by the symptoms of obstruction of the alimentary canal, diverticular duplication (3) was complicated by profuse bleeding, tubular duplication (6) was more often revealed in the rectum (4). Correct diagnosis before the operation was established in 5 patients. Choice of a method for operation is individual. The results of treatment are favourable.

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A method for creation of the artificial smooth muscle anal sphincter, which was used in 18 children with high forms of anorectal atresia and in 9 children with associated incompetence of the external and internal anal sphincters developed after repeated operations, severe traumas of the perineum and rectum and suppurative processes, has been developed. The effectiveness of the developed method is shown on the basis of clinical, functional and experimental morphologic methods of investigation.

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The clinical manifestations, diagnosis and results of the treatment of 52 children, suffering from teratomas of the sacrococcygeal region, are presented. The optimal time for the performance of surgical intervention is defined. Three newborns and 3 children, operated on at the age over 1 year with malignization of teratoma, died.

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The authors describe methods of surgical treatment of 63 children with recurrent and acquired fistulas of the rectum with genitourinary system, specific features of the surgery depending on the character of the pathologic state. An original method of the abdomino-perineal proctoplasty and improved means of draining the wounds are presented. Questions of preoperative preparation and postoperative management are discussed.

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