Department of Pediatric Surgery, University of Medicine and Pharmacy at Ho Chi Minh City, 217 Hong Bang, Ward 11, District 5, Ho Chi Minh City, Vietnam.
Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
Pediatr Surg Int. 2023 Feb 14;39(1):124. doi: 10.1007/s00383-023-05415-z.
To evaluate outcomes of adopting the Swenson-like technique in transanal pull-through for Hirschsprung disease (HD) at a children's institution in Southeast Asia.
A retrospective chart review was performed over 42 months at a safety-net pediatric hospital in Vietnam.
From January 2019 to June 2022, the Swenson-like technique was implemented and performed on 139 patients (115 male, 24 female, mean age 6.4 ± 11.96 months). There were 123 transanal-only resections, 5 transanal plus laparoscopic, and 11 transanal plus laparotomy. The mean operative time was 70.9 ± 43.6 min. The average length of the resected specimen was 18.8 ± 10.9 cm. No urethral or vaginal injuries occurred. Postoperative complications included 1 anastomotic leak (0.7%), 4 anastomotic stenoses (2.8%), and 2 perianal abscesses in the setting of recurrent enterocolitis (1.4%). With a mean follow-up of 26 ± 11.9 months (range 3-48 months), there were 25 enterocolitis cases (17.9%), 45 patients with constipation (32.3%), 1 episode of fecal incontinence lasting longer than 6 months (0.7%), and 1 rectal-vestibular fistula noted one year postoperatively (0.7%). There were no deaths.
The Swenson-like technique in transanal pull-through for Hirschsprung's disease was safely adopted at our institution. The results show that applying this technique uniformly in a single institution led to excellent outcomes.
评估在东南亚一家儿童医院采用 Swenson 类似技术行经肛门拖出术（transanal pull-through）治疗先天性巨结肠（Hirschsprung disease，HD）的结果。
在越南一家儿童医院，对 42 个月期间的病历进行回顾性分析。
2019 年 1 月至 2022 年 6 月，采用 Swenson 类似技术对 139 例患者（男 115 例，女 24 例，平均年龄 6.4±11.96 个月）进行了治疗。其中，123 例行单纯经肛门切除术，5 例行经肛门联合腹腔镜切除术，11 例行经肛门联合剖腹探查术。平均手术时间为 70.9±43.6 分钟。切除标本的平均长度为 18.8±10.9cm。无尿道或阴道损伤。术后并发症包括吻合口漏 1 例（0.7%），吻合口狭窄 4 例（2.8%），以及在复发性小肠结肠炎的情况下发生 2 例肛周脓肿（1.4%）。平均随访 26±11.9 个月（范围 3-48 个月），17.9%（25 例）出现小肠结肠炎，32.3%（45 例）出现便秘，1 例大便失禁持续时间超过 6 个月（0.7%），1 例术后 1 年出现直肠前庭瘘（0.7%）。无死亡病例。
在我院，Swenson 类似技术行经肛门拖出术治疗先天性巨结肠是安全的。结果表明，在单一机构中统一应用该技术可获得良好的结果。
