Department of Surgery, University of the West Indies, Mona, Jamaica.
Colorectal Dis. 2011 Apr;13(4):454-8. doi: 10.1111/j.1463-1318.2009.02174.x.
This study reviewed the operative management and outcome of patients with adult Hirschsprung's disease treated at the University Hospital of the West Indies, Mona, Jamaica.
The case notes for 11 patients with adult Hirschsprung's disease, treated operatively between January 1986 and December 2007, were reviewed and data on preoperative diagnosis, operative procedures and postoperative complications were retrieved.
Diagnosis was by open rectal biopsy in nine patients and by rectal suction biopsy in two patients. The time taken for preoperative bowel preparation ranged from 10 to 35 days, and colostomy was required in three patients to facilitate bowel cleansing. The Soave and Swenson procedures were used in six and five patients, respectively, leading to anastomotic stricture in one patient treated using the Soave procedure and to leakage in two patients treated using the Swenson procedure. All procedures took longer than 300 min, and 300-800 ml of blood or plasma was transfused.
Therapeutic procedures for adult Hirschsprung's disease may result in life-threatening anastamotic complications. A protective colostomy is recommended when Swenson's procedure is used.
本研究回顾了牙买加莫纳西印度群岛大学医院治疗成人先天性巨结肠症患者的手术治疗方法和结果。
对 1986 年 1 月至 2007 年 12 月期间接受手术治疗的 11 例成人先天性巨结肠症患者的病历进行了回顾，检索了术前诊断、手术过程和术后并发症的数据。
9 例患者经直肠活检确诊，2 例患者经直肠吸引活检确诊。术前肠道准备时间为 10-35 天，3 例患者需要结肠造口术以促进肠道清洁。6 例患者采用 Soave 手术，5 例患者采用 Swenson 手术，其中 1 例采用 Soave 手术的患者出现吻合口狭窄，2 例采用 Swenson 手术的患者出现漏诊。所有手术均耗时超过 300 分钟，输血量为 300-800 毫升。
成人先天性巨结肠症的治疗方法可能导致危及生命的吻合口并发症。当使用 Swenson 手术时，建议行保护性结肠造口术。
