术前管理包括使用经肛门留置管对先天性巨结肠病婴儿进行管灌洗，可以进行一期根治性手术。
Preoperative management comprising tube irrigation using a trans-anal indwelling tube for infants with hirschsprung disease can allow single-stage radical surgery.
机构信息
Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
Department of Rare/Intractable Cancer Analysis Research, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
出版信息
BMC Surg. 2023 Nov 1;23(1):333. doi: 10.1186/s12893-023-02232-y.
BACKGROUND
Preoperative management of Hirschsprung's disease (HD) is currently being conducted with the goal of performing single-stage radical surgery without ileostomy.
METHODS
We retrospectively reviewed HD cases between 2013 and 2022, as well as their outcomes related to preoperative management.
RESULTS
Thirty-nine patients with HD were included in this study, including short-segment HD (30 cases), long-segment HD (4 cases), and total colonic aganglionosis (5 cases). Among these 39 patients, 95% (37 of 39 patients) underwent single-stage radical surgery after management with glycerin enema use (n = 13), irrigation with tube insertion each time irrigation was performed (n = 13), and irrigation using a tube placed in the bowel (n = 11).
CONCLUSIONS
Preoperative management of patients with HD allowed for single-stage surgery of long-segment HD and total colonic aganglionosis. Cases that could be managed without performing an emergency enterostomy during the neonatal period were managed with irrigation until radical surgery was performed.
背景
目前，先天性巨结肠症（HD）的术前管理旨在进行无造口术的单阶段根治性手术。
方法
我们回顾性分析了 2013 年至 2022 年间的 HD 病例及其与术前管理相关的结果。
结果
本研究共纳入 39 例 HD 患者，其中短段型 HD 30 例，长段型 HD 4 例，全结肠无神经节细胞症 5 例。这 39 例患者中，95%（37/39 例）在接受甘油灌肠（n=13）、每次插管冲洗（n=13）和在肠道内置管冲洗（n=11）管理后行单阶段根治性手术。
结论
HD 患者的术前管理可实现长段型 HD 和全结肠无神经节细胞症的单阶段手术。对于新生儿期无需行紧急肠造口术的病例，可通过冲洗管理，直至行根治性手术。
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