Primary transanal rectosigmoidectomy for Hirschsprung's disease: Preliminary results in the initial 33 cases
Primary transanal rectosigmoidectomy for Hirschsprung's disease: Preliminary results in the initial 33 cases
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DOI：
10.1053/jpsu.2001.28847
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发表时间：
2001-12-01
影响因子：
2.4
通讯作者：
Li, GW
中科院分区：
文献类型：
--
作者：
Gao, Y;Li, GC;Li, GW
目的：作者介绍了他们的新技术--原发性经肛门直肠乙状结肠切除术治疗先天性巨结肠（HD）及其在新生儿和婴儿中的初步结果。方法：34例（26名男孩）年龄18天至4岁，经活检证实的直肠乙状结肠HID患者接受了这种新手术。直肠黏膜切除术从齿状线后1 ~ 1.5cm、前2 ~ 3cm开始。在腹膜反射下方的直肠肌袖被切除到横纹肌复合体的水平，留下较短的肌袖，在其中进行部分内括约肌切开术。结果：手术时间平均160 min，切除肠管长度12.5 ~ 41 cm，平均29.5cm。2例儿童（6.06%，2/33）发生2 - 5次术后小肠结肠炎（EC）。一个治愈直肠冲洗和扩张，另一个由林恩的肌切除术，84%的患者有1至6排便，每天在6至18个月的随访periods.Conclusions：原发性经肛门直肠乙状结肠切除术HD是合理的，并与良好的早期结果。需要长期随访以确定肠功能。版权所有（C）2001 WB。桑德斯公司
Purpose: The authors describe their newly developed technique-primary transanal rectosigmoidectomy for Hirschsprung's disease (HD) and its preliminary results in neonates and infants,Methods: Thirty-four consecutive patients (26 boys) with biopsy-proven rectosigmoid HID, aged 18 days to 4 years, underwent this new procedure. Rectal mucosectomy started 1 to 1.5 cm posteriorly and 2 to 3 cm anteriorly proximal to the dentate line. The rectal muscular sleeve below the peritoneal reflection was resected to the level of the striated muscle complex, leaving a shorter muscular cuff, into which a partial internal sphincterotomy was made posteriorly. An oblique anastomosis was constructed between the pull-through ganglionic colon and the anus canal.Results: The mean time for the operation was 160 minutes, and the average length of bowel resected was 29.5 cm (range, 12.5 to 41 cm). Two children (6.06%, 2 of 33) had 2 to 5 episodes of postoperative enterocolitis (EC). One was cured by rectal irrigation and dilation, and the another by Lynn's myectomy, Eighty-four percent of patients had 1 to 6 bowel movements per day during a 6- to 18-month follow-up period.Conclusions: Primary transanal rectosigmoidectomy for HD is logical and associated with excellent early results. A longterm follow-up is required to determine bowel functions. Copyright (C) 2001 by WB. Saunders Company.