经肛门先天性巨结肠根治术的临床应用（附22例报告）  

Clinical Application of Transanal Radical Operation in the Treatment of Congenital Megacolon. Analysis of 22 Cases

作　　者：张素云[1] 刘鸣伟[1] 李国利[1] 张淑琴[1] 宗海涛[1] 

机构地区：[1]内蒙古赤峰市医院肛肠外科,内蒙古赤峰024000

出　　处：《中国肛肠病杂志》2007年第2期50-51,共2页Chinese Journal of Coloproctology

摘　　要：为探讨单纯经肛门先天性巨结肠根治术的临床应用，22例施行该术式。术前经钡剂灌肠摄片确定病变范围，常见型20例，短段型2例。在齿状线上约1．5cm左右离断直肠黏膜、后壁及侧壁离断全层，前壁在黏膜下层游离，直视下游离直肠乙状结肠，完善处理系膜血管，向上游离达正常肠管，拖出结肠与直肠断端全层结节吻合。结果显示，全部病例均经肛门完成，切除肠管平均长度21．8cm，平均手术时间118min，平均出血量约40ml，随诊3个月，1个月后排便基本正常。结果表明，单纯经肛门先天性巨结肠根治术适用于常见型、肛门型巨结肠患儿，手术创伤小，并发症少，效果满意。Twenty two patients underwent simple transanal radical operations for their congenital megacolons in the study. The diseased scope was confirmed by preoperative barium enema examination, which showed megacolons of common type in 20 cases,of short-segment type in 2 cases. The surgical procedure included incision of rectal mucosa at 1.5cm area from superior dental line, dissection of the rectal total layer off the posterior ＆ lateral walls, submucosal dissection of the anterior wall, dissection the rectum-sigmoid under direct vision, better management of mesenteric blood vessels,upward dissection to the normal colon, pull through the colon and rectum and total layer end-to-end colon-rectum anastomosis. All these surgical procedures were done transanally. The resected megacolon was 21.8cm in average, the average operation period of time was 118 minutes,and the average bleeding volume was 40ml. 3-month follow up showed that defecation became basic normal one month after operation in all cases. It is concluded that simple transanal rectal operation in the treatment of congenital megacolon is feasible for young children with megacolon of common type and anus type due to less trauma, less complication and satisfactory effect.

关 键 词：先天性巨结肠 结直肠手术 临床应用 

分 类 号：R656.9[医药卫生—外科学]