Rohatgi M, Gupta D K
Department of Paediatric Surgery, All India Institute of Medical Sciences, New Delhi.
J Pediatr Surg. 1989 Feb;24(2):177-9. doi: 10.1016/s0022-3468(89)80243-x.
The isolated ileal-loop endorectal pull-through was performed on two patients with Hirschsprung's disease complicated by disuse atrophy of the distal colon. In both patients there was not only a short length of the proximal ganglionic colon, which could not be safely pulled down to the perineum, but also nonavailability of the distal aganglionic colon, which had to be resected for nonfunctioning disuse atrophy. This technique allowed a safe endorectal pull-through with primary anal anastomosis, and also prevented complications like frequent watery diarrhea, steatorrhea, malabsorption of vitamins A, D, and K, and pernicious anemia frequently observed following popular surgical procedures for long-segment and total colonic aganglionsis.
对两名患有先天性巨结肠并伴有远端结肠废用性萎缩的患者进行了孤立回肠袢经直肠拖出术。两名患者不仅近端神经节结肠长度短，无法安全拖至会阴，而且远端无神经节结肠因废用性萎缩失去功能而必须切除。该技术实现了经直肠安全拖出并一期肛门吻合，还预防了常见于长段和全结肠无神经节症流行手术之后的频繁水样腹泻、脂肪泻、维生素A、D和K吸收不良以及恶性贫血等并发症。
