Onishi Shun, Nakame Kazuhiko, Kaji Tatsuru, Kawano Masato, Moriguchi Tomoe, Sugita Koshiro, Yano Keisuke, Nomura Mioko, Yamada Koji, Yamada Waka, Masuya Ryuta, Kawano Takafumi, Machigashira Seiro, Mukai Motoi, Ieiri Satoshi
Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan.
Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan.
J Pediatr Surg. 2017 Dec;52(12):2001-2005. doi: 10.1016/j.jpedsurg.2017.08.036. Epub 2017 Sep 2.
BACKGROUND/PURPOSE: Hirschsprung disease (HD) is considered curable, but the postoperative bowel function is not always satisfactory. In this study, we evaluated the general condition, bowel function, and social performance in adults who were older than 17years of age who had undergone definitive operations in childhood.
From 1984 to 2016, 110 patients with HD underwent definitive surgery at our institute. Sixty-three patients who had undergone the transabdominal Soave procedure reached 18years of age. Their present status and symptoms, anorectal function, genitourinary function, and social performance were evaluated during the clinical follow-up via a questionnaire survey.
The mean age of the questionnaire respondents was 25.0 (19-37) years. The bowel function was mostly good. However, 56% of patients had abdominal pain more than once a week. Regarding evacuation symptoms, incontinence and soiling occurred in 18.7%. Among the respondents 33.3% were married, and 60% of those who were married had children. The respondents had achieved success in their education and professional careers.
The bowel function of most patients was satisfactory, although some had chronic abdominal symptoms. Pediatric surgeons should continue trying to achieve complete bowel function after definitive surgery of HD.
Prospective Cohort Study.
Level III.
背景/目的:先天性巨结肠症(HD)被认为是可治愈的,但术后肠道功能并不总是令人满意。在本研究中,我们评估了17岁以上在儿童期接受根治性手术的成年人的一般状况、肠道功能和社会表现。
1984年至2016年,110例HD患者在我院接受了根治性手术。63例接受经腹Soave手术的患者年满18岁。通过问卷调查在临床随访期间评估他们目前的状况和症状、肛肠功能、泌尿生殖功能和社会表现。
问卷调查受访者的平均年龄为25.0(19 - 37)岁。肠道功能大多良好。然而,56%的患者每周腹痛不止一次。关于排便症状,18.7%的患者出现大便失禁和便污。在受访者中,33.3%已婚,已婚者中有60%育有子女。受访者在教育和职业生涯中取得了成功。
大多数患者的肠道功能令人满意,尽管有些患者有慢性腹部症状。小儿外科医生应继续努力在HD根治性手术后实现完全的肠道功能。
前瞻性队列研究。
三级。