乙状结肠冗长症的术式选择探讨

目的 探讨乙状结肠冗长症患儿的术式选择.方法 1998～2008年共收治乙状结肠冗长症患儿83例,根据术中冰冻切片检查结果,并参照临床表现、直肠测压、造影及术中所见等采用不同的手术方法,对神经元无异常的病例采用单纯乙状结肠切除术;对神经元有异常的病例采用各种途径的根治直结肠大斜面吻合术或乙状结肠切除＋直肠内括约肌切除术.结果 61例痊愈,复发2例,均为单纯乙状结肠切除术后患儿,切口感染1例,肛周湿疹3例.结论 乙状结肠冗长症患儿术中应常规行冰冻切片病理检查,根据肠壁神经元有无病变采取不同的手术方法.

Initiatory exploration of the standard of surgical treatment methods for Dolichosigmoid

Objective The purpose of this study is to introduce the standard of different surgical treatment methods for Dolichosigmoid. Methods Sixty three patients underwent different operations between June 1998 and December 2008 were reviewed retrospectively. According to the result of intraoperative frozen section, or clinical symptoms, anoreetal manometry, barium enema to select different surgical methods, hemicolectomy for those whose neurons is normal and modified Swenson operation for abnormal neurons. Results Recurrence in 2, both were the patients who underwent hemicolectomy, infection of incisional wound in 1, perianal eczema in 3. Conclusions Frozen section should do during operation of Dolichosigmoid. According to the result of it,we select different surgical methods.