经肛门一期直肠内拖出术治疗先天性巨结肠：51例新生儿患者的经验
Transanal one-stage endorectal pull-through for Hirschsprung disease: experiences with 51 newborn patients.
作者信息
Vũ Pham Anh, Thien Ho Huu, Hiep Pham Nhu
机构信息
Department of Surgery, Hue College of Medicine and Pharmacy, Hue, Vietnam.
出版信息
Pediatr Surg Int. 2010 Jun;26(6):589-92. doi: 10.1007/s00383-010-2599-0. Epub 2010 Apr 27.
INTRODUCTION
Transanal one-stage endorectal pull-through (TOSEPT) has been presented as the most recent progression in the treatment of Hirschsprung's disease (HD), which may be able to replace various previous techniques. This prospective study was designed to evaluate the efficacy and probable complications of this procedure in management of newborns with HD.
MATERIALS AND METHODS
Fifty-one newborns (33 boys and 18 girls) underwent TOSEPT; all after being diagnosed by barium enema and rectal biopsy over a 52-month period. All patients were followed-up up from 6 to 48 months after hospital discharge.
RESULTS
There was no per-operative complication. Laparotomy was necessary in five children (9.8%). Average length of aganglionosis segment was 13.9 cm +/- 6.0 cm. Mean postoperative hospitalization time was 7.1 days. TOSEPT was redone in two patients (3.9%) because of aganglionosis segment remaining. After 6-48 months of follow-up, all children have been well now.
CONCLUSION
Our data suggested that TOSEPT is efficacious and safe in the management of newborn with HD.
引言
经肛门一期直肠内拖出术（TOSEPT）被视为先天性巨结肠（HD）治疗的最新进展，可能会取代之前的各种技术。本前瞻性研究旨在评估该手术在治疗HD新生儿中的疗效及可能出现的并发症。
材料与方法
51例新生儿（33例男童，18例女童）接受了TOSEPT手术；均在52个月的时间内通过钡剂灌肠和直肠活检确诊。所有患者在出院后均随访了6至48个月。
结果
术中无并发症发生。5例患儿（9.8%）需要进行剖腹手术。无神经节段的平均长度为13.9厘米±6.0厘米。术后平均住院时间为7.1天。2例患者（3.9%）因残留无神经节段而再次进行TOSEPT手术。经过6至48个月的随访，所有患儿目前情况良好。
结论
我们的数据表明，TOSEPT在治疗HD新生儿方面有效且安全。
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