Zang Jingyu,Yuan Xiaojian,Cheng Siyang,et al.The efficacy analysis of different operative methods in treating Total Colonic Aganglionosis (TCA) in a Single Center.[J].Journal of Clinical Pediatric Surgery,,17():106-111.
The efficacy analysis of different operative methods in treating Total Colonic Aganglionosis (TCA) in a Single Center.
Journal of Clinical Pediatric Surgery[ISSN:1671-6353/CN:43-1380/R]
volume:
第17卷
Number:
2018 02
Page:
106-111
Column:
专题讨论
Date of publication:
2018-02-28
- Keywords:
- Total Colonic Aganglionosis; Hirschsprung Disease; Surgical Procedures; Operative; Enterocolitis
- Document code:
- A
- Abstract:
- ObjectiveThis study retrospectively reviewed the clinical data of TCA patients in our hospital from 2001 to 2016 and compared the outcomes of each surgical procedure of TCA.Methods53 patients (37 males with average age of 12.9±3.6 months) were diagnosed with TCA between 2001 and 2016.All patients were treated with secondary radical operation.According to the methods of operation,the patients were divided into three groups which were Jpouch,Duhamel and Soave procedures.The relevant data of preoperative clinical manifestations,surgical methods,postoperative complications and longterm outcomes were collected and reviewed.ResultsAmong the 53 cases,13 children (9 males) performed Jpouch procedure from 2001 to 2005 while 12 children (10 males) performed Duhamel procedure from 2006 to 2010 and 28 children (18 males) underwent Soave procedure from 2011 to 2016.The operation time of the Soave group (2.8±0.9 h) was significantly shorter than the Jpouch group (4.1±1.2)h and the Duhamel group (3.7± 1.1)h (F=7.695,P<0.001).The hospitalization time of the Soave group (8.9±2.3)d was significantly shorter than the Jpouch group (15.9±2.8)d and the Duhamel group (13.9±2.1)d (F=41.820,P<0.001).The incidence of perianal erosion in the Soave group was significantly higher than that in the other two groups (χ2=14.770,P<0.001).There was no significant difference in intestinal function among the three groups in the long term (χ2=0.663，P>0.05).ConclusionThe transperineum Soave radical operation were a relatively safe and effective surgical method with shorter operation time and hospitalization time.Children had better defecation function and their developmental condition was basically normal in a longterm followup.A pathological Hirschsprungassociated enterocolitis (HAEC) score for the remaining small intestine segments can probably predict the occurrence of postoperative HAEC.
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