Sowande O A, Adejuyigbe O
Department of Surgery, Pediatric Surgery Unit, Obafemi Awolowo University Teaching Hospital, PMB 5538, Ile Ife, Osun State, Nigeria.
J Indian Assoc Pediatr Surg. 2008 Jan;13(1):14-7. doi: 10.4103/0971-9261.42567.
Swenson's pull-through is one of the standard operations for the treatment of children with Hirschsprung's disease. Complications arising from the operation are difficult to treat because of fibrosis in the pelvis. The posterior sagittal approach may be a safer alternative.
The aim of this paper is to highlight our experience with the use of the posterior sagittal trans-sphincteric approach to treat unusual complications of Swenson's pull-through.
A retrospective study of four patients who had posterior sagittal repair of their complications of Swenson pull-through at the Obafemi Awolowo University Teaching Hospital, Ile Ife, Nigeria.
Four cases of Hirschsprung's disease that developed post-Swenson pull-through complications are presented. There were three males and one female. Their age ranged between 10 months and 15 years. The patients had rectovaginal fistula, rectourethral fistula, high trans-sphincteric fistula-in-ano and complete anastomotic disruption.
All the patients were successfully treated using the posterior sagittal approach. The approach was used twice in one patient without significant sequelae. The three patients were old enough to be assessed and had a Kelly score of 4-6 at follow-up.
The posterior sagittal technique offers a safe approach to treat the complications of Swenson pull-through.
斯文森拖出术是治疗先天性巨结肠症患儿的标准手术之一。由于盆腔纤维化，该手术引发的并发症难以治疗。后矢状入路可能是一种更安全的选择。
本文旨在突出我们使用后矢状经括约肌入路治疗斯文森拖出术异常并发症的经验。
对在尼日利亚伊费奥巴费米·阿沃洛沃大学教学医院接受后矢状入路修复斯文森拖出术并发症的4例患者进行回顾性研究。
介绍4例先天性巨结肠症患者在斯文森拖出术后出现的并发症情况。其中男性3例，女性1例。年龄在10个月至15岁之间。患者分别出现直肠阴道瘘、直肠尿道瘘、高位经括约肌肛瘘和完全性吻合口破裂。
所有患者均采用后矢状入路成功治疗。1例患者使用该入路两次，未出现明显后遗症。3例年龄较大的患者能够接受评估，随访时凯利评分在4 - 6分。
后矢状技术为治疗斯文森拖出术并发症提供了一种安全的方法。
