经肛门改良Soave术和经腹手术治疗先天性巨结肠疗效比较

目的探讨经肛门改良Soave术和经腹手术治疗先天性巨结肠的临床疗效。方法2001～2007年作者收治年龄〉3岁的先天性巨结肠患儿41例，其中28例采取经肛门改良Soave术，24例经腹手术，分析两组患儿术后并发症以及排便功能。结果两组并发症的发生率比较，经肛门改良Soave术明显少于经腹手术，先天性巨结肠相关性肠炎（Himchsprung’s associatedentero colitis，HAEC）的发生率低于经腹手术，差异有统计学意义。两组排便控制能力以及大便形态方面比较，经肛门改良Soave术优于经腹手术。结论经肛门改良Soave术治疗先天性巨结肠安全可行，疗效优于经腹手术，但术后仍有诸多并发症，特别在排便控制方面，需要大宗病例长期随访的研究来评估。

A comparison of resul : transanal va transabdominal approach for hirschsprung' s disease

Objective The aim of this study was to comparison the result ：Transanal va Transabdominal Approach for Hirschsprung, s disease（HD）. Methods 41 patients who Underwent operation for HI）（ transanal approach, n = 20 ; transabdominal approach, n = 21 ） were reviewed between 1995 ~ 2003. clinical outcome was assessed retrospectively. Results complications were lower in the transanal approach group than transabdominal approach. The continence and the stool pattern were better in the transanal approach group than transabdominal approach group. Conclutions The transanal endorectal pull-through for HD is a feasible and safe procedure, but there were still some complications especially for stool continent, so careful long-term follow-up is required to assess the clinical outcome.