Höllwarth M E, Rivosecchi M, Schleef J, Deluggi S, Fasching G, Ceriati E, Ciprandi G, DePeppo F
Department of Pediatric Surgery, University of Graz, Medical School, Garz, Austria.
Pediatr Surg Int. 2002 Sep;18(5-6):344-8. doi: 10.1007/s00383-002-0747-x. Epub 2002 Jul 10.
The transanal approach (TAA) is a new technique for surgery of Hirschsprung's disease (HD) that was introduced by de la Torre in 1998. The purpose of this multicenter study, including experience from three Austrian and one Italian departments of peadiatric surgery, was to evaluate the role of this approach in HD in 18 children aged 1-72 months. In 14 children the TAA only was performed; in 3 an additional laparoscopy was performed and in 1 conversion to a laparotomy was necessary. One complication (abscess) occurred after laparoscopic-assisted pull-through. The postoperative recovery was rapid, no severe long-term problems were observed. The transanal pull-through technique is generally possible in most classic cases of HD with extension of the disease to the sigmoid colon. If necessary, it can be combined with laparoscopy. Our preliminary results show that the technique is safe, less invasive, and gives excellent cosmetic results, and allows rapid recovery. Long-term results are still pending.
经肛门入路（TAA）是一种治疗先天性巨结肠（HD）的新技术，由德拉托雷于1998年引入。这项多中心研究纳入了奥地利三个和意大利一个儿科手术科室的经验，旨在评估该入路在18例1至72个月大儿童HD治疗中的作用。14例患儿仅接受了TAA手术；3例额外进行了腹腔镜检查，1例需要转为开腹手术。腹腔镜辅助拖出术后发生了1例并发症（脓肿）。术后恢复迅速，未观察到严重的长期问题。经肛门拖出术在大多数HD经典病例中通常是可行的，疾病可延伸至乙状结肠。如有必要，可与腹腔镜检查联合使用。我们的初步结果表明，该技术安全、侵入性小、美容效果极佳，并能实现快速恢复。长期结果仍有待观察。
