临床小儿外科杂志2018，Vol.17Issue(2)：106-111,6.DOI:10.3969/j.issn.1671-6353.2018.02.006
单中心不同手术方式治疗全结肠型巨结肠疗效分析
The efficacy analysis of different operative methods in treating Total Colonic Aganglionosis(TCA)in a Single Center
摘要
Abstract
Objective This study retrospectively reviewed the clinical data of TCA patients in our hospi-tal from 2001 to 2016 and compared the outcomes of each surgical procedure of TCA.Methods 53 patients (37 males with average age of 12.9 ±3.6 months)were diagnosed with TCA between 2001 and 2016.All pa-tients were treated with secondary radical operation.According to the methods of operation,the patients were di-vided into three groups which were J-pouch,Duhamel and Soave procedures.The relevant data of preoperative clinical manifestations,surgical methods,postoperative complications and long-term outcomes were collected and reviewed.Results Among the 53 cases,13 children(9 males)performed J-pouch procedure from 2001 to 2005 while 12 children(10 males)performed Duhamel procedure from 2006 to 2010 and 28 children(18 males)underwent Soave procedure from 2011 to 2016.The operation time of the Soave group(2.8 ±0.9 h) was significantly shorter than the J-pouch group(4.1 ±1.2)h and the Duhamel group(3.7 ±1.1)h(F=7.695,P<0.001).The hospitalization time of the Soave group(8.9 ±2.3)d was significantly shorter than the J-pouch group(15.9 ±2.8)d and the Duhamel group(13.9 ±2.1)d(F=41.820,P<0.001).The incidence of perianal erosion in the Soave group was significantly higher than that in the other two groups(χ2=14.770,P<0.001).There was no significant difference in intestinal function among the three groups in the long term(χ2=0.663,P>0.05).Conclusion The trans-perineum Soave radical operation were a relatively safe and effective surgical method with shorter operation time and hospitalization time.Children had better defecation function and their developmental condition was basically normal in a long-term follow-up.A pathological Hirschsprung-asso-ciated enterocolitis(HAEC)score for the remaining small intestine segments can probably predict the occur-rence of postoperative HAEC.关键词
全结肠巨结肠/Hirschsprung病/外科手术/小肠结肠炎Key words
Total Colonic Aganglionosis/Hirschsprung Disease/Surgical Procedures/Operative/En-terocolitis引用本文复制引用
臧婧羽,袁小建,程思旸,洪志华,王俊,陈杰..单中心不同手术方式治疗全结肠型巨结肠疗效分析[J].临床小儿外科杂志,2018,17(2):106-111,6.基金项目
新华医院院级科研课题项目(JZPI201708) （JZPI201708）
