Clinical pathology of the ileocaecal junction in childhood and justification of its reconstruction as part of the autologous intestinal reconstructive surgery

Folaranmi, Semiu Eniola

Clinical pathology of the ileocaecal junction in childhood and justification of its reconstruction as part of the autologous intestinal reconstructive surgery

dc.contributor.advisor	Cserni, Tamás
dc.contributor.advisor	Rákóczy, György
dc.contributor.author	Folaranmi, Semiu Eniola
dc.contributor.department	Klinikai orvostudományok doktori iskola	hu
dc.contributor.submitterdep	DE--OEC--Általános Orvostudományi Kar -- DE--OEC--Általános Orvostudományi Kar --
dc.contributor.submitterdep	DE--OEC--Általános Orvostudományi Kar --
dc.contributor.submitterdep	DE--OEC--Általános Orvostudományi Kar --
dc.date.accessioned	2014-03-17T15:16:24Z
dc.date.available	2014-03-17T15:16:24Z
dc.date.created	2014	hu_HU
dc.date.defended	2014-03-26
dc.description.abstract	This thesis focuses on the clinical importance of the ileocaecal junction. Shows evidence and justifies attempts for its surgical reconstruction in Short Bowel Syndrome, Crohn’s disease and in otherwise healthy children. In the first section using clinical database analyses, the surgical conditions leading to loss of the original ileocaecal junction in children were established. The main cause leading to loss of the ileocaecal junction is age related: necrotising enterocolitis in the newborn period, intussusception in infancy, complicated appendicitis and inflammatory bowel disease and large bowel volvulus in adolescence. Accurate diagnosis of these conditions and the appreciation of the value of the ICV may prevent the need for resection of the valve. In the second section the long term complications seen after the loss of the ileocaecal junction is analysed in otherwise healthy patients. Three groups of patients underwent limited hemicolectomy, hemicolectomy and resection of 10-25 cm ileum have been statistically compared. The results showed the loss of the original junction has significant long term morbidity. 27% of the patients developed long term diarrhoea and it comes only from the loss of the ileocaecal valve. The loss of 10-25 cm terminal ileum and the loss of the ascending colon have no significant role in the postoperative complications. In the third section the relation of the intact ICV and the survival in Short Bowel Syndrome has been analysed. Our results suggested that a significantly shorter (40.5 ± 7.74 cm vs. 74 ± 29.0 cm) small bowel length is required for survival if the ICV is intact. In the fourth section we looked at patients with Crohn’s disease undergoing surgical intervention and ileocaecal resection. It was shown that a very high rate (75%) of chronic diarrhoea and disease recurrence (50%) occurred after loss of the ICV. However this is not attributable only to loss of the ICV. CD patients, especially, may benefit from preservation or reconstruction of the ICV. Our results showed that ileocaecal valve reconstruction should be considered as part of Autologous Gastrointestinal Reconstructive Surgery in Short Bowel Syndrome. Patients with Crohn’s disease and even otherwise healthy patients may benefit from ileocaecal reconstruction as well.	hu_HU
dc.format.extent	73	hu_HU
dc.identifier.uri	http://hdl.handle.net/2437/181723
dc.language.iso	en	hu_HU
dc.subject	ileocaecal valve	hu_HU
dc.subject	autologue gastrointestinal reconstructive surgery
dc.subject	short bowel
dc.subject.discipline	Klinikai orvostudományok	hu
dc.subject.sciencefield	Orvostudományok	hu
dc.title	Clinical pathology of the ileocaecal junction in childhood and justification of its reconstruction as part of the autologous intestinal reconstructive surgery	hu_HU
dc.title.translated	Clinical pathology of the ileocaecal junction in childhood and justification of its reconstruction as part of the autologous intestinal reconstructive surgery	hu_HU