Falchetti D, Dessanti A, Villanacci V, Iannuccelli M
Department of Pediatric Surgery, Spedali Civili, Piazza Spedali Civili 1, 25100 Brescia, Italy.
Surg Endosc. 2004 Apr;18(4):717-8. doi: 10.1007/s00464-003-4264-3. Epub 2004 Jan 23.
Transanal endorectal resection and colonic pull-through (TERPT) is a good technique for the management of Hirschsprung's disease. This procedure is feasible in the vast majority of patients and is associated with excellent results, early postoperative recovery, and no visible scars. We report the case of a patient who developed early postoperative severe constipation after TERPT due to unusual folding of the muscular cuff rim, which tightly narrowed the pulled-through colon. This complication was diagnosed and treated by laparoscopy. To prevent it, we recommend splitting of the aganglionic muscular cuff during TERPT.
经肛门直肠内切除术及结肠拖出术（TERPT）是治疗先天性巨结肠的一种良好技术。该手术在绝大多数患者中是可行的，且具有良好的效果、术后早期恢复快以及无明显瘢痕等优点。我们报告一例患者，其在TERPT术后因肌袖缘异常折叠导致拖出的结肠严重狭窄而出现早期严重便秘。该并发症通过腹腔镜检查得以诊断和治疗。为预防此并发症，我们建议在TERPT术中切开无神经节的肌袖。
