Carcassonne M, Morisson-Lacombe G, Letourneau J N
J Pediatr Surg. 1982 Jun;17(3):241-3. doi: 10.1016/s0022-3468(82)80005-5.
From Jan 1, 1965 to Nov 1, 1980, 155 infants with Hirschsprung's disease have been treated. All had confirmed aganglionosis at multiple rectal biopsies. From 1965 to 1969, 54 patients underwent a Swenson's procedure at an age ranging from 12 to 18 months after a preliminary colostomy. 13 patients died between colostomy and definitive operation. From 1969 to 1977, the delay in performing corrective operation after colostomy was shortened and the definitive procedure was done between 6 and 11 months of age in 69 patients. No fatality was observed but in 9 cases a perianal dermatitis lowered the quality of functional results. From 1977 to Nov 1, 1980, progress in immediate nursing and total parenteral nutrition made colostomy unnecessary in 19 neonates and infants with severe Hirschsprung's disease. The definitive surgical procedure (mainly Swenson's) was performed before 3 months of age. The postoperative results were excellent. After more than 4 years of follow-up for the first cases, the good secondary results, the quality o defecation, and the shortening of total hospital time, allow us to advocate this method in selected cases.
从1965年1月1日至1980年11月1日，共治疗了155例患有先天性巨结肠症的婴儿。所有患儿均经多次直肠活检确诊为无神经节细胞症。1965年至1969年，54例患者在先行结肠造口术后，于12至18个月龄时接受了斯文森手术。13例患者在结肠造口术至最终手术期间死亡。1969年至1977年，结肠造口术后进行矫正手术的延迟时间缩短，69例患者在6至11个月龄时完成了最终手术。未观察到死亡病例，但有9例出现肛周皮炎，影响了功能结果的质量。1977年至1980年11月1日，即时护理和全胃肠外营养方面的进展使19例患有严重先天性巨结肠症的新生儿和婴儿无需进行结肠造口术。最终的外科手术（主要是斯文森手术）在3个月龄前进行。术后结果极佳。对首批病例进行了4年多的随访后，良好的继发结果、排便质量以及总住院时间的缩短，使我们主张在特定病例中采用这种方法。
