经肛门结肠拖出术治疗小儿先天性巨结肠--附57例报告-《中国微创外科杂志》

文章信息/Info

Title:: Transanal colon pull-through operation for the treatment of Hirschsprung's disease in children

Author(s):: Liu Baofu; Huang Liuming; Liu Gang; et al.; Department of Pediatric Surgery,Peking University First Hospital,Beijing 100034,China

Keywords:: Hirschsprung’s disease (HD)　Transanal colon pull-through operation

摘要:: 目的探讨单纯经肛门结肠拖出术治疗小儿先天性巨结肠的可行性. 方法 2001年7月～2002年5月,57例巨结肠患儿行经肛门结肠拖出术. 结果 53例顺利完成单纯经肛门结肠拖出术,手术时间(1～2)小时,平均1.5小时,出血5ml～10ml.51例术后1天开始自行排便、进食, 2例术后3天予开塞露灌肠后排便.4例长段型巨结肠,病变累及横结肠,在腹腔镜辅助下完成,手术时间(2～3.5)小时,平均3小时,术后(2～3)天开始排便、进食.随访(2～9)月,57例患儿排便功能均正常良好. 结论单纯经肛门结肠拖出巨结肠根治术治疗小儿先天性巨结肠可行,此术式损伤小、出血少、术后恢复快、住院时间短,术后排便功能恢复良好.

Abstract:: Objective　To explore the feasibility of simple transanal colon pull-through operation in the management of Hirschsprung’s disease(HD) in children.　Methods　57 case of HD were performed by transanal macrocolon pull-through operation from July 2001 toMay 2002.　Results　53 cases underwent simple transanal co- lon pull-through operation successfully. The mean operative time was 1.5h (1h~2h) and blood loss was 5ml~ 10ml. Dejection and food taking recovered at the first day after operation in 51 patients; dejection recovered at the third day after operation in 2 patients. 4 patientswith long segmental macrocolon, implicated in transverse colon, were operated on by laparoscope-assited surgery, and they began to defecate and take food in 2d~3d postoperatively. The mean operative time was 3h(2h~3.5h). 57 cases had been followed up for (2~9)months, and their dejection function recovered well.　Conclusions　It is feasible to treat HD in children through simple transanal colon pull- through operation. The method has the advantages of minimal invasion, less bleeding, quicker recovery, shorter hos- pital stay and good recovery of dejection function.