Küçükaydin M, Okur H, Turan C, Içer M, Zorlu M, Kazez A
Department of Pediatric Surgery, Erciyes University, Faculty of Medicine, Kayseri, Turkey.
Eur J Surg. 1993 Sep;159(9):487-9.
To describe our experience with Swenson's operation for Hirschsprung's disease done during the neonatal period.
Retrospective study.
University department of paediatric surgery.
10 Neonates with Hirschsprung's disease.
Rectosigmoidectomy and pull through (Swenson's operation), with covering transverse colostomy.
Mortality, morbidity, and continence.
The median age at definitive operation was 25 days (range 15-35). There was one late death three weeks after discharge from hospital of respiratory and cardiac failure. Two patients presented with caecal perforation and two with intestinal obstruction; in all four Hirschsprung's disease was diagnosed on frozen section, a transverse colostomy was done, and the Swenson's operation was done electively. The other six were diagnosed by barium enema examination and biopsy, and underwent total bowel irrigation followed by Swenson's operation and transverse colostomy. The colostomies were closed three to four weeks later. There were no postoperative complications. All nine surviving patients were continent (3-4 stools/day), at a mean (SD) follow up of 21 (5) months.
With the current high standards of anaesthesia and neonatal intensive care, and an experienced surgeon, Swenson's operation for neonatal Hirschsprung's disease is safe and the procedure of choice for this condition.
描述我们在新生儿期进行的先天性巨结肠Swenson手术的经验。
回顾性研究。
大学儿科外科。
10例先天性巨结肠新生儿。
直肠乙状结肠切除术及拖出术（Swenson手术），并行覆盖式横结肠造口术。
死亡率、发病率和大便控制情况。
确定性手术时的中位年龄为25天（范围15 - 35天）。有1例在出院3周后因呼吸和心力衰竭晚期死亡。2例出现盲肠穿孔，2例出现肠梗阻；在所有这4例中，先天性巨结肠在冰冻切片上被诊断出来，先行横结肠造口术，然后择期进行Swenson手术。另外6例通过钡剂灌肠检查和活检确诊，先行全肠道灌洗，随后进行Swenson手术和横结肠造口术。结肠造口术在3至4周后关闭。无术后并发症。在平均（标准差）21（5）个月的随访中，所有9例存活患者大便控制良好（每天3 - 4次大便）。
鉴于目前高标准的麻醉和新生儿重症监护，以及经验丰富的外科医生，新生儿先天性巨结肠的Swenson手术是安全的，也是这种疾病的首选术式。
