不同年龄段先天性巨结肠根治术的探讨

目的探讨不同手术方法对不同年龄段先天性巨结肠的治疗。方法3例小于6个月的婴幼儿采用非开腹经肛门结肠拖出术治疗巨结肠;7例1～14岁患儿采用Ikeda1]手术治疗;2例成人采用胃肠吻合器应用Ikeda手术治疗。结果9例Ikeda术式中,发生炎症性肠梗阻1例,经对症处理痊愈,无其它手术并发症,随访5个月～4年,排便恢复正常,无便秘、污粪等现象。结论不同年龄段的先天性巨结肠可采用不同的术式,以创伤小、并发症少、恢复快、效果好为选择标准。对婴儿的短段型、常见型病例首选经肛门巨结肠根治术;对大龄儿童及成人,则优先选用Ikeda法。

Discussion about surgery on congenital megacolon in different ages

Objective To explore thoroughly therapeutic surgery on congenital megacolon in different ages.Method Three infants under six months were therapied for megacolon by duhamel operation viaanus. Seven children aged 1 to 14 year were therapied by Ikeda operation. Two adults were therapied by Ikeda operation in stomach-intestines anastomat.Results Among nine Ikeda operation, only one had inflammatory intestinal obstruction. Cured by disposal treat, the one did not have other operative complications. During the follow-up period of 5 months to 4 years, defecation recovered and phenomena such as constipation were not observed.Conclusion According to choosing norms including little trauma, few complications, quick recovery and good results, congenital megacolon in different ages can be therapied by different methods of operation, In terms of infants cases which belongs to short segment and common type, thoroughly therapeutic surgeries via anus on congenital megacolon are firstly selected. While the case are older children and adults, Ikeda operations are primarily selected.