非开腹式经肛门结肠拖出术治疗小儿先天性巨结肠症  

Trans-anal colonic pull-through for Hirschsprung's disease

作　　者：易军[1] 蒋嘉萍[1] 李涛[1] 姜斌[1] 陈一丁[1] 刘大林[1] 刘继炎[1] 谷兴琳[1] 

机构地区：[1]南京医科大学附属南京儿童医院外科,南京210008

出　　处：《中华小儿外科杂志》2001年第5期265-266,共2页Chinese Journal of Pediatric Surgery

摘　　要：目的　报道既不用开腹 ,也不需腹腔镜 ,在微创的情况下实现对小儿先天性巨结肠症的根治术式。方法　采用经肛门斜行切断直肠 (前高后低 ) ,处理直肠、结肠系膜 ,拖出病变肠管并予以切除 ,结、直肠I期斜面吻合的方法 ,治疗短段型 (5例 )及普通型 (18例 )巨结肠共 2 3例。结果　全部患者手术获得成功 ,术后无须扩肛 ,随访 1～ 12个月 ,排便正常 ,未出现不良并发症。结论　非开腹式 ,经肛门拖出并切除病变结肠 ,是一种全新的手术路径。它在实现对巨结肠根治的同时 ,获得了最佳的美容效果 ,并降低了一定的术后并发症。Objective A new minimally invasive operation on Hirschsprung's disease without laparotomy or laparoscopy is reported.Methods Twenty-three patients with Hirschsprung's disease ( 5 short-segment type and 18 common type) underwent trans-anal slant rectotomy (higher anterior and lower posterior). Mesorectum and mesocolon were dissected. The dilated segment of colon was pulled out and resected. One stage slant colo-rectal anastomosis was performed. Results All patients recovered with normal defecation, and no complication was observed during the 1-12 months follow-up period. Post-operative rectal dilation was not required. Conclusions Trans-anal pull-through colorectal anastomosis without laparotomy is a new approach for Hirschsprung's disease. This operation is suitable for Hirschsprung's disease with relatively short affected segment. It offers good visualization and reduces post-operative complications.

关 键 词：先天性巨结肠 肛门吻合术 肛门结肠拖出术 

分 类 号：R726.5[医药卫生—儿科]