直肠肌鞘内结肠拖出术特有并发症的治疗和预防

目的 探讨减少直肠肌鞘内拖出术特有并发症及采取行之有效的治疗和预防。方法 对１３４例行直肠肌鞘内拖出术病例进行回顾性分析,其中结肠拖出１２７例,回肠拖出７例,术后２周内出现特有并发症２８例（２０．６％）,其中肌鞘感染９例（６．６％）,鞘内结肠假性梗阻１４例（１０％）、鞘内肠管上缩５例（３．７％）,因特有并发症死亡３例（２．２％）。结果 分析３各特有并发症发生的原因、临床特征及防治措施,证实前后采用

Complications of Endorectal Pull-through Procedure

Objective The purpose of this study was to review the complications of endorectal pull through procedure and establish means to minimize complications. Methods One hundred and thirty four endorectal pull through procedures including colonic pull through (127) and ileal pull through (7) were reviewed. Results Of the 28 complications, there were 9 cases of abscess formation in the muscular cuff ( 6.6% ), 14 cases of intestinal pseudo obstruction (10%) and 5 of retraction of pull through bowel ( 3.7% ). Three patients died of the complications ( 2.2% ). Perioperative administration of antibiotics and aseptic technique during operation reduced the abscess formation rate from 8.2% to 1.8% . Insertion of anorectal tube prevented pseudo obstruction. Meticulous anastomosis lessened retraction of pull through bowel. Conclusions Endorectal pull through procedure is acceptable treatment for Hirschsprung, sdiesase. The complications are preventable.