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改良 Soave 经肛门拖出术治疗先天性巨结肠术式中斜形与圆形吻合的比较:哪种更好?

OBLIQUE VS. CIRCULAR ANASTOMOSIS IN THE CHILDREN UNDERWENT SOAVE'S PULL-THROUGH SURGERY FOR THE TREATMENT OF HIRSCHSPRUNG'S DISEASE: WHICH IS THE BEST?

机构信息

Pediatric Surgery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Khouzestan, Iran.

Alimentary Tract Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Khouzestan, Iran.

出版信息

Arq Bras Cir Dig. 2021 Jan 15;33(3):e1545. doi: 10.1590/0102-672020200003e1545. eCollection 2021.

Abstract

BACKGROUND

Oblique type of anastomosis. Several types of complications including constipation, fecal soiling, perianal excoriation, were reported among different types of surgery for Hirschsprung's disease.

AIM

To compare circular and oblique anastomoses following Soave's procedure for the treatment of Hirschsprung's disease.

METHODS

Children who underwent Saove's pull through procedure with oblique and circular anastomoses were included. Duration of the follow up was two years after surgery. Postoperative complications, such as wound infection, wound dehiscence, peritonitis, fecal soiling, perianal excoriation, were recorded for each patient.

RESULTS

Thirty-eight children underwent oblique anastomoses. Circular ones were done for 32 children. Perianal excoriation was seen in 57.89% and 46.87% of children in oblique and circular group, respectively. Enterocolitis was more frequent in circular (40.62%) than oblique (28.94%) group. Anastomotic stricture was more frequent in circular (15.62%) than oblique (7.89%).

CONCLUSION

Perianal excoriation was the most common complication among patient in both groups. Oblique anastomoses had fewer complications than circular, and may be appropriate option for patient who underwent Soave's procedure.

摘要

背景

斜型吻合术。不同类型的巨结肠症手术都有报道出现包括便秘、粪便污染、肛周皮肤破损等并发症。

目的

比较经肛门 Soave 拖出术行圆形和斜形吻合术治疗先天性巨结肠的效果。

方法

纳入接受 Soave 经肛门拖出术且行斜形和圆形吻合术的患儿。术后随访 2 年。记录每位患者的术后并发症,如伤口感染、伤口裂开、腹膜炎、粪便污染、肛周皮肤破损等。

结果

38 例行斜形吻合术,32 例行圆形吻合术。斜形组和圆形组分别有 57.89%和 46.87%的患儿出现肛周皮肤破损。圆形组(40.62%)比斜形组(28.94%)更常发生结肠炎。圆形组吻合口狭窄(15.62%)比斜形组(7.89%)更常见。

结论

在两组患儿中,肛周皮肤破损是最常见的并发症。斜形吻合术比圆形吻合术的并发症少,可能是 Soave 手术后患儿的合适选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c157/7812688/f8d982a99cee/0102-6720-abcd-33-03-e1545-gf1a.jpg

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