Transanal Endorectal vs. Duhamel Pull-Through for Hirschsprung's Disease
Transanal Endorectal vs. Duhamel Pull-Through for Hirschsprung's Disease
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DOI：
10.1055/s-0030-1252006
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发表时间：
2010-07-01
影响因子：
1.8
通讯作者：
Arnbjornsson, E.
中科院分区：
文献类型：
--
作者：
Gunnarsdottir, A.;Larsson, L. -T.;Arnbjornsson, E.
前言：本研究的目的是验证这样一种假设，即直肠乙状结肠巨结肠症(HD)患者的早期功能结果与Duhamel拉通术和经肛门直肠内拉通术(TERPT)相似，而TERPT技术术后患者的不适感更少。材料和方法：前瞻性登记11例采用TERPT技术的患者(T组)，并与18例Duhamel拉通术(D组)的患者进行回顾性比较。记录的数据包括患者人口统计、手术治疗、并发症、住院时间和肠道功能。结果：T组开始进食时间较早，排便时间较早，术后对镇痛的需求较少，住院时间明显较短。D组71%的患者需要再次干预，而T组只有18%。两组患者中均有2例出现小肠结肠炎。在最后一次临床对照中，D组有10名患者(59%)有便秘，3名患者有污垢(18%)。T组有3例患者便秘(27%)，1例有污物(9%)。结论：我们的结果支持使用TERPT方法而不是Duhamel牵引术治疗直肠乙状结肠HD。
Introduction: The aim of this study was to test the hypothesis that the early functional outcome for patients with rectosigmoid Hirschsprung's disease (HD) is comparable for the Duhamel pull-through procedure and the transanal endorectal pull-through (TERPT) procedure, with less discomfort for the patient postoperatively after the TERPT technique.Material and methods: Eleven patients operated on with the TERPT technique (T Group) were prospectively registered and compared retrospectively with 18 patients operated on with the Duhamel pull- through (D Group). Data recorded included patient demographics, operative treatment, complications, hospital stay bowel functions. The follow-up time was limited to 24 months.Results: The T Group started oral feeding sooner, their bowel movements started sooner and they had less need for analgesia postoperatively and a signifi cantly shorter hospital stay. 71% of the patients in the D Group needed re-intervention compared to only 18% of the T Group. Enterocolitis was seen in two patients in both groups. At the last clinical control ten patients had constipation (59%) and three had soiling (18%) in the D Group. Three patients in the T Group had constipation (27%) and one had soiling (9%).Conclusion: Our results support the use of the TERPT method rather than the Duhamel pullthrough for rectosigmoid HD.