巨结肠次全或左半结肠切除术后的远期排便功能比较

Long - term outcome of operation on Hirschsprung＇s disease： subtotal colectomy versus left colectomy procedure

目的比较先天性巨结肠次全或左半结肠切除术后患儿不同时期的排便功能，了解两组切除不同范围的结肠对患儿远期排便功能及生长发育的影响。方法将128例先天性巨结肠行心形吻合术患儿分为两组：一组为左半结肠切除，共56例；另一组为结肠次全切除，共72例。两组随访4～12年，比较两组的排便功能、生活质量、生长发育及便秘复发等情况。结果术后半年的排便功能比较，左半结肠切除组患儿评估明显好于次全切除组，而2年后两组的排便功能、生活质量比较差异无统计学意义。次全切除组便秘复发1例，左半切除组便秘复发5例。对身高／年龄及体重／年龄评估得出，两组患儿在各百分位范围内的比例差异无统计学意义。结论结肠次全切除患儿远期排便功能与左半切除患儿相比差异无统计学意义，生活质量及生长发育两组均可以达到正常范围，左半结肠切除的患儿便秘复发率比次全切除要高。

Objective To make comparison between outcome of subtotal colectomy and left colectomy on Hirsehsprung＇s disease （HD） in children. Methods One hundred and twenty - eight HD cases treated by heart - shaped anastomosis procedure were reviewed,in which 72 patients underwent subtotal colectomy and 56 received left colectomy. Postoperative follow- up period ranged from 4 tol2 years. The bowel function in different stages, quality of life and growth and development after operation between two groups were analyzed and compared. Results The bowel function score in subtotal eolectomy group was obviously lower than that in left colectomy group at the 6th month after operation. However, there was no difference in evaluation of bowel function, growth and development and quality of life after 2 years. Conclusion The long - term outcome of subtotal colectomy was as good as that of left colectomy procedure. The quality of life and growth and development of the two groups was be same as normal. And the rate of recurrent constipation in left coleetomy group was higher.