Koh Chee-Chee, Sheu Jin-Cherng, Wang Nien-Lu, Lee Hung-Chang, Chang Pei-Yeh, Yeh Ming-Lun
Division of Pediatric Surgery, Mackay Memorial Hospital, No. 92, Chung-Shan North Road Sec. 2, Taipei, 10449, Taiwan.
Pediatr Surg Int. 2006 Sep;22(9):725-8. doi: 10.1007/s00383-006-1748-y. Epub 2006 Aug 5.
Intussusception in children may recur after surgical correction. Ileopexy has popularly been used as a procedure to prevent recurrent intussusception, but its effect has not been well evaluated. The present study compared the incidence of recurrent intussusception after several different surgical procedures for intussusception in children. The charts of 278 children undergoing surgical reduction of ileocolic intussusception over 17 years were retrospectively reviewed. The incidence of recurrent intussusception was compared among the three surgical procedures: simple manual reduction, manual reduction plus ileopexy, and segmental resection. Simple manual reduction was performed in 67 (24.1%) of the 278 patients, manual reduction plus ileopexy in 186 (66.9%), and resection of the involved segment in 25 (9.0%). There were four episodes of recurrence in three (4%) patients who had had manual reduction, nine episodes in eight (4%) patients who had undergone ileopexy, and none after segmental resection. There was no statistical difference in recurrent rate among the three groups (reduction vs. ileopexy, P = 0.95; reduction vs. resection, P = 0.28; ileopexy vs. resection, P = 0.29). Ileopexy is not better than simple manual reduction in preventing recurrence of ileocolic intussusception in children.
儿童肠套叠在手术矫正后可能会复发。回肠固定术一直被广泛用作预防复发性肠套叠的一种手术,但它的效果尚未得到充分评估。本研究比较了几种不同手术治疗儿童肠套叠后复发性肠套叠的发生率。回顾性分析了17年间278例接受回结肠套叠手术复位的儿童病历。比较了三种手术方式后复发性肠套叠的发生率:单纯手法复位、手法复位加回肠固定术和节段性切除。278例患者中,67例(24.1%)接受单纯手法复位,186例(66.9%)接受手法复位加回肠固定术,25例(9.0%)接受受累节段切除。单纯手法复位的3例(4%)患者中有4次复发,接受回肠固定术的8例(4%)患者中有9次复发,节段性切除后无复发。三组之间的复发率无统计学差异(复位术与回肠固定术相比,P = 0.95;复位术与切除术相比,P = 0.28;回肠固定术与切除术相比,P = 0.29)。在预防儿童回结肠套叠复发方面,回肠固定术并不比单纯手法复位更好。