成人先天性巨结肠症的诊断和治疗

目的成人先天性巨结肠症的诊断和手术方法的探讨。方法对本院31例成人先天性巨结肠症的临床表现,诊断和手术方法,进行了回顾性分析。结果 29例行 Swenson 手术,1例 Duhamel 手术,术后并发吻合口瘘5例(16.7%)。早期吻合口狭窄2例,28例获得随访,完全恢复正常排便功能23例(78%),4例轻度排便失禁,1例完全排便失禁。结论成人巨结肠症手术后并发症较婴幼儿高。全结肠显著肥厚扩张时,保留回盲部的手术,术后并发吻合口瘘的发生率高;采用全结肠直肠切除回肠直肠末端吻合,并作预防性回肠造瘘术,可预防吻合口瘘的发生。

The diagnosis and treatment of adult hirschsprung's disease

Objective To evaluate the surgical treatment effect and diagnosis of adult hirschsprung's disease. Method To retrospective analyze the clinic material of 31 cases of adult Hirschsprung's disease.Results Swenson's procedure was perfrormed on the 29 patients and Duhamel procedure on 1 caseae.Postoperative anastomotic leak in 5 patients 16.7% and anastomotic stenosis in 2 patients were recorded 1.Of twenty-eight follow-up patients,23 patients(78%)had normal bowel habits,4 patients exhibited slight incontinence of faeces and one patient severed incontinence of faeces.Conclusion The incidence of postoperative Compliactions in adult Hirschsprung's disease is higher than that in children.As total colon is markedly hypertrophic and dilated,and the operation is performed with ileocecum preserved,the incidence of anastomosis leak is high.To prevent anastomotic leak total colorectal resection with temporary ileostomy is safe and effective for ileo-anus anastomosis in adult Hirschsprung's disease.