Ralls Matthew W, Coran Arnold G, Teitelbaum Daniel H
C.S. Mott Children's Hospital, University of Michigan Hospital and Health Systems, Ann Arbor, MI, USA.
Semin Pediatr Surg. 2012 Nov;21(4):354-63. doi: 10.1053/j.sempedsurg.2012.07.011.
Despite most children undergoing a successful pull through for Hirschsprung disease, a small portion of children are left with persistent stooling issues. Most of these stooling issues can be addressed by nonoperative approaches. However, in a small group of remaining children, a reoperation may be necessary. Most children who may need a redo pull-through procedure may have a persistent area of aganglionosis, unremitting enterocolitis, or a torsion or stricture of the pull-through segment. Each of these influences the approach the surgeon must take to correct the presenting problem. The chapter details the diagnostic approach as well as the operative techniques, which best deal with each of these complications.
尽管大多数患有先天性巨结肠症的儿童通过拖出术获得了成功，但仍有一小部分儿童存在持续的排便问题。这些排便问题大多可以通过非手术方法解决。然而，在一小部分剩余的儿童中，可能需要再次手术。大多数可能需要再次进行拖出术的儿童可能存在持续的无神经节细胞症区域、持续性小肠结肠炎，或拖出段扭转或狭窄。这些情况中的每一种都会影响外科医生纠正当前问题所必须采取的方法。本章详细介绍了诊断方法以及手术技术，这些技术能最好地处理这些并发症中的每一种。
