Xiong Xiaofeng, Chen Xiaoai, Wang Guo, Feng Jiexiong
Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
J Pediatr Surg. 2015 Dec;50(12):2044-7. doi: 10.1016/j.jpedsurg.2015.08.027. Epub 2015 Aug 28.
The aim of this study was to evaluate the long term quality of life among adults who had undergone heart-shaped anastomosis for Hirschsprung's disease (HD) during childhood.
Ninety-two cases with HD who had undergone heart-shaped anastomosis between January 1986 and January 1995 were investigated, and 90 adults with pediatric surgical and gastrointestinal disorders during the same period were randomly collected to serve as controls. They were to complete bowel function score (BFS) and WHO Quality of Life-BREF (QLB).
In BFS, there was significant difference in soiling between the HD group and the control group. Eight patients presented occasional soiling, with six of them having undergone two or more operations. Comparing persons without soiling in the HD group and controls, no significant difference was found in each area of QLB, and there was significant difference in psychology and low quality of life subjective feelings in the soiling group compared with the other HD persons and controls, respectively.
The long-term outcome of heart-shaped anastomosis for Hirschsprung's disease is satisfying. Recurrent operation is a high risk for soiling occurrence. It should be emphasized to remove all the lesion segment in the first operation.
本研究旨在评估儿童期接受心形吻合术治疗先天性巨结肠症（HD）的成年人的长期生活质量。
对1986年1月至1995年1月期间接受心形吻合术的92例HD患者进行调查，并随机收集同期90例患有小儿外科和胃肠道疾病的成年人作为对照。他们需完成肠道功能评分（BFS）和世界卫生组织生活质量简表（QLB）。
在BFS中，HD组和对照组在粪便污染方面存在显著差异。8例患者偶尔出现粪便污染，其中6例接受过两次或更多次手术。比较HD组和对照组中无粪便污染的人，QLB各领域均未发现显著差异，且粪便污染组与其他HD患者和对照组相比，在心理和生活质量主观感受低方面存在显著差异。
先天性巨结肠症心形吻合术的长期效果令人满意。再次手术是发生粪便污染的高风险因素。应强调在首次手术中切除所有病变段。
