Hirose R, Adachi Y, Bandoh T, Yoshida T, Sato K, Kitano S
Department of Surgery I, Oita Medical University, Japan.
Surg Today. 1999;29(4):371-4. doi: 10.1007/BF02483067.
We describe herein a primary laparoscopic pull-through procedure that was successfully employed to treat two infants with Hirschsprung's disease. Mobilization of the rectum and sigmoid colon was performed laparoscopically, and the rectal mucosa was removed via a transanal submucosal resection. After inducing the rectal prolapse intussusceptically, the rectum was circumferentially transected, and the mobilized colon was pulled down through the rectal muscle cuff. Resection of the aganglionic bowel and the coloanal anastomosis, using the Soave-Denda method, was performed outside the anus. Both infants had an uneventful postoperative course with early recovery of bowel movement. Our experience demonstrates that this minimally invasive surgical procedure is feasible for young infants, and we believe that Hirschsprung's disease may be a definite indication for laparoscopic surgery.
我们在此描述一种原发性腹腔镜拖出术，该手术成功用于治疗两名患有先天性巨结肠症的婴儿。通过腹腔镜进行直肠和乙状结肠的游离，经肛门黏膜下切除术切除直肠黏膜。通过套叠诱导直肠脱垂后，将直肠环形横断，游离的结肠经直肠肌袖拖下。采用Soave-Denda法在肛门外切除无神经节肠段并进行结肠肛管吻合。两名婴儿术后恢复顺利，排便功能早期恢复。我们的经验表明，这种微创手术对幼儿是可行的，我们认为先天性巨结肠症可能是腹腔镜手术的明确适应证。
