Komissarov I A, Svarich V G, Khasaev Kh M
Khirurgiia (Mosk). 1992 Nov-Dec(11-12):35-8.
Among the criteria of evaluation of the results of operative treatment of Hirschsprung's disease in children, along with the absence of constipation is the function of defecation control. The authors examined 27 patients with fecal incontinence after Duhamel's operation. It was established that fecal incontinence in children after operative treatment of Hirschsprung's disease may be caused not only by affection of the external sphincter muscle of the anus, the nerve plexuses, and adaptation of the rectum to the new conditions after the pull-through operation, but also by trauma inflicted to the levator ani muscle. In children with severe damage to the levator group of muscles consequent upon operative treatment of Hirschsprung's disease, operative intervention for creating the anorectal angle is indicated.
在评估儿童先天性巨结肠症手术治疗效果的标准中,除便秘消失外,排便控制功能也是一项标准。作者检查了27例经杜哈梅尔手术后出现大便失禁的患者。结果发现,儿童先天性巨结肠症手术治疗后出现大便失禁,不仅可能是由于肛门外括约肌、神经丛受到影响以及直肠在拖出手术后适应新环境所致,还可能是由于提肛肌受到损伤。对于因先天性巨结肠症手术治疗导致提肛肌群严重受损的儿童,建议进行手术干预以形成肛管直肠角。