Department of Surgery, International Center for Colorectal and Urogenital Care, Division of Pediatric Surgery, University of Colorado School of Medicine, University of Colorado, Colorado, USA.
Departamento de Cirugía Pediátrica, Hospital Infantil de México Federico Gómez, Mexico City, Mexico.
Bol Med Hosp Infant Mex. 2023;80(6):331-338. doi: 10.24875/BMHIM.23000050.
Surgeons create a neorectum to repair patients with Hirschsprung's disease (HD), which should be formed from a normoganglionic bowel. However, the neorectum is occasionally created with a transition zone (TZ) bowel. A neorectum created with a TZ has been postulated as a cause of postoperative enterocolitis or constipation. This study compares the incidence of enterocolitis and constipation in patients with TZ neorectum and normoganglionic bowel.
We conducted a retrospective review of patients with rectosigmoid HD who underwent primary pull-through. Patients were divided into normoganglionic neorectum (NNR) and TZ neorectum. The diagnosis was based on the final histopathologic report of the proximal margin. The incidence of enterocolitis and constipation was compared between these two groups.
A total of 98 HD patients were analyzed. Seventy-one patients fulfilled the inclusion criteria. 65 (92%) had a NNR, and six patients (8%) had a TZ neorectum. From these patients, 42 (59%) presented with enterocolitis or constipation. However, there was no significant difference between both groups.
The present study showed no difference in the incidence of enterocolitis or postoperative constipation in HD patients with normoganglionic or TZ neorectum. These results suggest that TZ neorectum does not cause postoperative obstructive symptoms.
外科医生为先天性巨结肠（HD）患者创建新直肠，该新直肠应源自正常神经节的肠段。然而，新直肠偶尔会由过渡区（TZ）肠段形成。据推测，由 TZ 形成的新直肠是术后肠炎或便秘的原因之一。本研究比较了 TZ 新直肠和正常神经节肠段患者的肠炎和便秘发生率。
我们对接受原发性经肛门拖出术的直肠乙状结肠 HD 患者进行了回顾性研究。患者被分为正常神经节新直肠（NNR）和 TZ 新直肠。根据近端边缘的最终组织病理学报告进行诊断。比较两组之间肠炎和便秘的发生率。
共分析了 98 例 HD 患者。71 例符合纳入标准。65 例（92%）为 NNR，6 例（8%）为 TZ 新直肠。这些患者中，42 例（59%）出现肠炎或便秘。然而，两组之间无显著差异。
本研究显示，在具有正常神经节或 TZ 新直肠的 HD 患者中，肠炎或术后便秘的发生率无差异。这些结果表明，TZ 新直肠不会引起术后梗阻症状。
