改良Duhamel术式治疗成人先天性巨结肠七例

Modified Duhamel operation on seven cases of adult Hirschsprung's disease

目的:探讨成人先天性巨结肠(HD)的外科治疗。方法:对我院2003年1月—2008年5月收治的7例成人HD患者行改良Duhamel术式治疗。其中男3例,女4例,年龄18～53岁。普通型巨结肠3例,短段型2例,长段型1例,全结肠型1例。结果:术后1例发生盆腔积液,1例发生吻合口炎,均治愈;另5例顺利治愈。7例患者均无污粪、大便失禁及盲袋闸门综合征等,3例男性患者无性功能障碍。结论:改良Duhamel术式能够有效治疗成人HD,术后复发少,术后性功能及排便功能优良。

Objective：To investigate the surgical treatment of adult Hirschsprung＇s disease （AHD）. Methods： A retrospective clinical analysis was proceeded in 7 cases of AHD treated in our hospital from January 2003 to May 2008. There were 3 males and 4 females with an age ranged from 18 to 53 years,including three cases with general segment type,two cases with short segment type,one case with long segment type and one case with whole segment type. All cases were received the modified Duhamel operation. Results： All cases had satisfactory outcome without serious complications,such as soiling, blind pouch syndrome, fecal incontinence and sexual disorder in male patients. Pelvic hydrops occurred in one case and anastomotic inflammation occurred in another case,and both were cured by intensive therapy. Conclusion： The Modified Duhamel Operation is an effective and safe procedure for AHD. Through this procedure the postoperative recurrence rate is reduced, as well the sexual function and the defecate function are remained .