Taguchi Tomoaki, Ieiri Satoshi
Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Nihon Geka Gakkai Zasshi. 2009 Jul;110(4):184-90.
Hirschsprung's disease has been considered to be curable with definitive surgery. However, postoperative bowel function is not always satisfactory. We evaluated the general condition, bowel function, and social performance using a questionnaire survey among adults who had Hirschsprung's disease in childhood. In our series, the evacuation score was "excellent" (score of 7-8/8) in 67.5%, "good" (5-6/8) in 20%, "fair" (34/8) in 10%, and "poor" (0-2/8) in 2.5%. Therefore 87.5% were considered to have satisfactory bowel function. However, only 25% had a score of 8/8. Incontinence occurred in 17.5%, and soiling was also reported by 17.5% of the questionnaire respondents. Genitourinary function was considered to be within the normal range, and urinary problems were minimal. Among the respondents, 47.5% were married and 68.4% of those had children. Educational and professional careers were reasonable. In general, bowel function was satisfactory. However, the ratio of patients whose bowel function was completely normal was low. Because incontinence and soiling impair the quality of life, pediatric surgeons should continue trying to achieve perfect bowel function after definitive surgery for the treatment of Hirschsprung's disease.
先天性巨结肠症一直被认为可通过根治性手术治愈。然而,术后肠道功能并非总能令人满意。我们通过问卷调查对童年时期患有先天性巨结肠症的成年人的一般状况、肠道功能和社会表现进行了评估。在我们的研究系列中,排便评分“优秀”(7 - 8分/8分)的占67.5%,“良好”(5 - 6分/8分)的占20%,“中等”(3 - 4分/8分)的占10%,“差”(0 - 2分/8分)的占2.5%。因此,87.5%的患者被认为肠道功能令人满意。然而,只有25%的患者得分为8分/8分。17.5%的患者出现大便失禁,17.5%的问卷受访者也报告有便污现象。泌尿生殖功能被认为在正常范围内,泌尿系统问题极少。在受访者中,47.5%已婚,其中68.4%育有子女。教育和职业发展情况合理。总体而言,肠道功能令人满意。然而,肠道功能完全正常的患者比例较低。由于大便失禁和便污会损害生活质量,小儿外科医生应继续努力在先天性巨结肠症的根治性手术后实现完美的肠道功能。