Kim C Y, Park J G, Park K W, Park K J, Cho M H, Kim W K
Department of Surgery, Chosun University Hospital, Kwangju, Korea.
Int J Colorectal Dis. 1995;10(3):156-60. doi: 10.1007/BF00298539.
Eleven patients with adult Hirschsprung's disease were treated at Seoul National University Hospital (SNUH, 8 cases) and Chosun University Hospital (CUH, 3 cases) between 1985 and 1992. Of the 11 patients, seven were male. The age of the patients ranged from 11 to 30 years, and all presented with chronic constipation and recurrent faecal impactions that required periodic enemas and laxatives. The Duhamel's operation, as a single or staged procedure, was performed in all patients. Levels of aganglionosis in 9 patients were confined to the rectosigmoid colon (82%). There were three major post-operative complications. Two patients developed fistula-in-ano at the anastomotic site, and one patient developed ileus. However, these complications resolved with conservative management. The longterm results were excellent except for one patient who developed impotence. The mean frequency of bowel movements was usually once or twice a day without the aid of other treatments. Our results indicate that Duhamel's operation is a highly acceptable procedure in the management of adult Hirschsprung's disease.
1985年至1992年间，首尔国立大学医院（SNUH，8例）和朝鲜大学医院（CUH，3例）共治疗了11例成人先天性巨结肠患者。11例患者中，7例为男性。患者年龄在11至30岁之间，均表现为慢性便秘和反复粪便嵌塞，需要定期灌肠和使用泻药。所有患者均接受了Duhamel手术，该手术可单次或分阶段进行。9例患者的无神经节病变局限于直肠乙状结肠（82%）。术后出现了三大并发症。2例患者在吻合口处发生肛瘘，1例患者发生肠梗阻。然而，这些并发症通过保守治疗得以解决。除1例患者出现阳痿外，长期效果良好。在无需其他治疗的情况下，肠道运动的平均频率通常为每天一次或两次。我们的结果表明，Duhamel手术是治疗成人先天性巨结肠的一种高度可接受的手术方法。
