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目的总结经肛门结肠拖出根治小儿乙状结肠冗长症的手术过程、疗效及短期随访。方法我院2000～2005年经该术式治疗小儿乙状结肠冗长症19例,乙状结肠冗长症有典型的便秘症状,钡灌肠显示19例乙状结肠比正常对照组平均长25 cm；直肠肛管测压显示直肠肛管松弛反射存在,呈“W”型特殊波型；组织化学检查无乙酰胆碱酯酶阳性的副交感神经纤维。结果19例经肛门拖出切除结肠肠管20～52 cm,平均切除结肠肠管28 cm。均于术后2～3 d开始进食,术后1个月随访每日排便6～8次,其中15例行钡灌肠检查未见结肠扩张,24 h无钡剂潴留。6个月随访(17例)每日排便1～3次,无污粪。结论经肛门结肠拖出根治小儿乙状结肠冗长症手术安全有效,具有创伤小、操作简单、近期疗效良好的特点。
Objective To summarize the surgical procedure, curative effect and short-term follow-up of the treatment of sigmoid colon gland rupture by transanal colon. Methods In our hospital from 2000 to 2005, 19 cases of pediatric sigillaris oblivion were treated by this technique. The typical symptoms of constipation were sigmoid colon. The barium enema showed 19 cases of sigmoid colon longer than the control group averagely 25 cm long. The rectal anal canal manometry showed that the rectum Reflex anal canal exists, was “W” type of special wave; histochemical examination without acetylcholinesterase-positive parasympathetic fibers. Results 19 cases of anus through the removal of the colon intestine 20 ~ 52 cm, the average removal of the colon intestine 28 cm. All patients began to eat 2-3 days after operation. One month follow-up was performed 6-8 times daily. Fifteen patients underwent barium enema without colon expansion and 24 hours without barium retention. 6 months follow-up (17 cases) 1 to 3 times a day defecation, no sewage manure. Conclusion It is safe and effective to pull off the treatment of sigmoid colon vermilion by transanal colon, which has the advantages of less trauma, simple operation and good curative effect in the near future.