Lan Menglong,Zeng Jixiao,Xu Xiaogang,et al.Redo pull-through for Hirschsprung’s disease with recurrent postoperative constipation[J].Journal of Clinical Pediatric Surgery,,20():230-235.[doi:10.12260/lcxewkzz.2021.03.006]
Redo pull-through for Hirschsprung’s disease with recurrent postoperative constipation
- Keywords:
- Hirschsprung Disease/SU; Constipation; Recurrence; Reoperation
- CLC:
- R726.1;R574;R574.62
- Abstract:
- Objective To explore the causes,surgical approaches and prognosis of recurrent postoperative constipation after surgery for Hirschsprung’s disease (HSCR).Methods Clinical data were analyzed retrospectively for 19 children who had undergone redo pull-through procedure for postoperative constipation of HSCR from July 2016 to July 2019.The causes for recurrent constipation included residual aganglionic segments (47.4%),acquired aganglionosis (31.6%),mechanical obstruction (15.7%) and motility disorder(5.3%).Reoperative approaches included Soave & Deloyers (n=9),laparoscopic assisted Swenson-like & Deloyers (n=4),laparoscopic assisted Soave (n=3),Soave (n=2),laparoscopic assisted Soave & Deloyers (n=1).Four cases underwent enterostomy for severe intestinal distension.The follow-up period was 18-54 months.Results All of them could defecate spontaneously after reoperation.The major complications were soiling (n=3,15.7%) and enterocolitis (n=1,5.3%).Conclusion The major causes for recurrent constipation of HSCR are residual aganglionic segments and acquired aganglionosis after pull-through procedure.After meticulous planning and reoperation,redo pull-through is both feasible and safe for HSCR.The short-term reoperative outcome is satisfactory.
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Memo
收稿日期:2021-01-13。
基金项目:国家自然科学基金（编号：82070528）；广东省自然科学基金（编号：2018A030313570）；先天性巨结肠发病机制及转归预后前瞻性队列研究（编号：ChiCTR-eoc-17013386）
通讯作者:曾纪晓,Email:zengjixiao@163.com