全结肠切除、回肠拖出Soave术一期治疗新生儿全结肠型巨结肠7例

Investigation of one stage straight ileo-anal pull-through Soave operation of total colonic aganglionosis in newborn

目的 ：探讨全结肠切除、回肠拖出Soave术一期治疗新生儿全结肠型巨结肠的方法及疗效。方法：2008年10月—2011年10月7例全结肠型巨结肠新生儿用全结肠切除、回肠拖出Soave术进行治疗,术后随访2~5年,进行体格检查及肛门功能Kelly评分。结果：7例患儿均手术顺利,无死亡。1例合并小肠结肠炎及电解质紊乱再次住院治疗,术后大便每天10~20次,6个月~1年后每天大便6~8次,2年后每天排便3~5次,大便基本成形,排便功能正常。7例患儿kelly评分优6例（85.7%）,良1例（14.3%）。结论：全结肠切除、回肠拖出Soave术一期治疗新生儿全结肠型巨结肠手术安全可靠,疗效确切,远期效果较好。

Objective： To explore the clinical feasibility and effect of One Stage straightileo-analpull-through Soave operation of totalcolonic aganglionosis in new born. Methods： 7 new-born（hospitalized during 2008 to 2011） with total colonic aganglionosis underwent one Stage straightileo-analpull-through Soave Operation. During the follow-up（2~5years）, anorectalfunction was assessed with Kelly score. Results： Operations of 7 individuals are all successful. The defecation frequency postoperative is 10 to 20 times everyday. And the num ber is decreased gradually. There are 6 to 8 times of defecation after 6 to 12 months, and 3 to 5 times of defecation 1year later. The stoolis form ing and the ability of bow lcontrolis good. The average Kelly score was（5.43±0.79）, all patients had satisfactory anorectal functions. Conclusion： One stage straight ileo-anal pull-through Soave operation is sim ilar with Martin traditional operation in the treatment of total colonic aganglionosis in new born.