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超越过渡区的延长切除的长度是否会改变Hirschsprung拉透的临床结果?

Sarah Ullrich¹, Naomi-Liza Denning¹, Monica Holder¹

¹Cincinnati Children's Hospital Colorectal Center, Cincinnati, OH, USA.

Journal of pediatric surgery

|October 21, 2023

概括

在希尔施普朗格病手术中,近端切除边缘较短不会增加并发症. 然而,较短的边际可能会导致更频繁的白天和自愿性排便,对整体便失禁的影响尚不清楚.

科学领域:

儿科手术儿科手术
胃肠病学胃肠病学
结肠直肠手术结肠直肠手术

背景情况:

扩展近接切除边缘 (EPM) 传统上用于赫施普朗病手术,以防止过渡区的穿透.
EPM>5厘米对术后结果的必要性和影响尚不清楚.
长时间的切除可能会损害血管供应,需要进一步切除肠道.

研究的目的:

评估扩展近端切除边缘 (EPM) 对手术后并发症和Hirschsprung病拉透手术患者的功能结果的影响.

主要方法:

87名患者的回顾性图表审查,这些患者接受了为希尔施普隆病 (2008-2022) 进行初级拉透.
定义了足够的近接边缘 (周围通常有状环,没有缩神经) 和延伸边缘 (近接结肠与正常状细胞的总长度).
使用儿科便失禁严重程度评分 (PFISS) 评估便失禁严重程度.

主要成果:

55%的患者EPM≤5厘米,45%的患者EPM>5厘米.
在 EPM 组之间,希尔施普朗相关肠球炎,拉透后转移或过渡区拉透的重新手术率没有显著差异.
患有EPM≤5厘米的患者在白天和自愿排便的频率较高,但其他便失禁测量没有显示差异.

结论:

较短的近位延伸边缘超出了适当的状边缘,在希尔施普朗格病手术中不会显著增加术后并发症率.
较短的EPM对便失禁严重性的影响尚不清楚,尽管观察到白天和自愿性排便的增加.

关键词:

功能性失禁是一种功能性失禁.希尔施普朗格相关的肠球炎赫什斯普朗格病是一种疾病.手术后的结果.通过拉动通过.过渡区的过渡区是一个过渡区.

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