手术治疗先天性巨结肠73例的体会

Experience of Surgical Treatment for 73 Cases Hirschsprung's disease

目的:探讨采用Swenson改良法手术治疗先天性巨结肠(HD)的手术方式及治疗效果。方法:术前清洁灌肠,对本组73例在肛门外套叠式拖出并切除病变的巨结肠,将正常结肠与直肠下段的吻合口一律吻合成前高后低的斜形,还纳后逐层关腹。结果:本组73例患儿均达到最大限度地保留肛门括约肌,保留其正常排便功能,未发生吻合口瘘等早期并发症,均痊愈出院。远期随访56例均未发生吻合口狭窄和其他晚期并发症,均达到良好效果。结论:Swenson改良法是治疗HD的较好术式之一,尤其适用于常见型和短段型及病变在升结肠以远的长段型。

Objective： To explore and summarize the the improving swenson＇s procedure for hirschs- prung＇s disease . Method： Before the operation ,the colon was cleaned thoroughly ,73 cases of the group underwent colonic pull - through and the dilated segment of colon was pulled out and resected. Normal colon and lower segment of rectum＇s stomosis were stomosed as diagonal shape（ higher anterior and lower posterior） After replacing the colon and stomosis , close the abdomen layer by layer. Result： All 73 cases anus sphincter muscle were retained at most degree , so that retained their function, of normal defecation . All 73 cases were healed and discharged , without early complications as stomosis fistila , et al . No anastomotic stricture or other late period complication was found in 56 cases with long period follow - up. Conclusion： Improving swensen~ procedure is a good method for Hirschsprung＇s disease ,especially fitful to the common type , short - segment type and long - segment type with diseased part in sigmoid colon .