Li Qi,Zhang Zhen,Li Long.Techniques and considerations of re-operations for Hirschsprung’s disease[J].Journal of Clinical Pediatric Surgery,2021,20(03):208-211.[doi:10.12260/lcxewkzz.2021.03.002]
先天性巨结肠再次手术的技术和思考
- Title:
- Techniques and considerations of re-operations for Hirschsprung’s disease
- 关键词:
- 先天性巨结肠/外科学; 手术后并发症; 再手术
- 分类号:
- R726.1;R574
- 摘要:
- 先天性巨结肠是小儿外科常见消化道畸形之一，其手术技术已经相对成熟，但仍有少数患者因术后中远期并发症而接受再次手术。本文回顾近年发表的相关文献，并结合自身临床经验，对先天性巨结肠根治术后并发症的病因、如何避免并发症的发生以及再次手术技巧进行系统阐述。
- Abstract:
- Hirschsprung’s disease (HSCR) is one of the most common congenital malformations leading to refractory constipation.Its surgical techniques have optimized.However,some complicated cases require re-operations.This review summarized the etiology and prevention of its complications and the improvements of surgical techniques based upon the relevant literature and our clinical experiences.
参考文献/References:
1 中华医学会小儿外科学分会肛肠学组、新生儿学组.先天性巨结肠的诊断及治疗专家共识[J].中华小儿外科杂志,2017,38(11):805-815.DOI:10.3760/cma.j.issn.0253-3006.2017.11.002. Groups of Anorectum and Neonatology,Society of Pediatric Surgery,Chinese Medical Association:Guidelines of Diagnosis and Treatment of Hirschspung’s disease[J].Chin J Pediatr Surg,2017,38(11):805-815.DOI:10.3760/cma.j.issn.0253-3006.2017.11.002.
2 Langer JC,Rollins MD,Levitt M,et al.Guidelines for the management of postoperative obstructive symptoms in children with Hirschsprung disease[J].Pediatric Surgery International,2017,33(5):523-526.DOI:10.1007/s00383-017-4066-7.
3 Ralls MW,Coran AG,Teitelbaum DH.Reoperative surgery for Hirschsprung disease[J].Seminars in Pediatric Surgery,2003,12(2):124-131.DOI:10.016/S1055-8586(02)00023-9.
4 中华医学会小儿外科学分会内镜外科学组.腹腔镜先天性巨结肠症手术操作指南(2017版)[J].中华小儿外科杂志,2017,38(4):247-254.DOI:10.3760/cma.j.issn.0253-3006.2017.4.002. Section of laparoscopic and Endoscopic Surgery,Branch of Pediatric Surgery,Chinese Medical Association:Guideline for Laparoscopic Pull-through for Hirschsprung’s Disease (2017 Edition)[J].Chin J Pediatr Surg,2017,38(4):247-254.DOI:10.3760/cma.j.issn.0253-3006.2017.04.002.
5 孙晓毅,李智,袁宏耀,等.失败的巨结肠根治术原因分析[J].中华小儿外科杂志,2014,35(7):491-494.DOI:10.3760/cma.j.issn.0253-3006.2014.07.004. Sun XY,Li Z,Yuan HY,et al.Reasons for failed megacolon radical operation[J].Chin J Pediatr Surg,2014,35(7):491-494.DOI:10.3760/cma.j.issn.0253-3006.2014.07.004.
6 Ralls MW,Coran AG,Teitelbaum DH.Redo pullthrough for Hirschsprung disease[J].Pediatric Surgery International,2017,33(4):455-460.DOI:10.1007/s00383-016-4045-4.
7 Dickie BH,Webb KM,Eradi B,et al.The problematic Soave cuff in Hirschsprung disease:Manifestations and treatment[J].J Pediatr Surg,2014,49(1):77-81.DOI:10.1016/j.jpedsurg.2013.09.034.
8 吕志葆.先天性巨结肠再次手术问题[J].中华实用儿科临床杂志,2014,29(23):1771-1773.DOI:10.3760/cma.j.issn.2095-428X.2014.23.004. Lv ZB.Reoperation for patients with Hirschsprung’s disease after a pull-through procedure[J].Chin J Appl Clin Pediatr,2014,29(23):1771-1773.DOI:10.3760/cma.j.issn.2095-428X.2014.23.004.
9 潘凯.腹腔镜结直肠癌根治术中结肠血管变异的应对措施[J].中华胃肠外科杂志,2013,16(10):944-946.DOI:10.3760/cma.j.issn.1671-0274.2013.010.010. Pan K.Counter-measures for anatomic variations of colonic vessels during radical laparoscopy for colorectal cancer[J].Chin J Gastrointest Surg,2013,16(10):944-946.DOI:10.3760/cma.j.issn.1671-0274.2013.010.010.
10 Zhang JS,Li L,Hou WY,et al.Transanal rectal mucosectomy and partial internal anal sphincterectomy for Hirs-chsprung’s disease[J].J Pediatr Surg,2014,49(5):831-834.DOI:10.016/j.jpedsurg.2014.02.042.
11 李龙,刘树立,付京波,等.经肛门直肠黏膜及内括约肌切除术治疗先天性巨结肠的技术要点和疗效[J].中华小儿外科杂志,2008,29(9):515-518.DOI:10.3760/cma.j.issn.0253-3006.2008.09.002. Li L,Liu SL,Fu JB,et al.Rectal mucosectomy and internal anal sphincterectomy for children with Hirscbsprung’s disease[J].Chin J Pediatr Surg,2008,29(9):515-518.DOI:10.3760/cma.j.issn.0253-3006.2008.09.002.
12 Li Q,Li L,Jiang Q,et al.The mid-term outcomes of TRM-PIAS,proctocolectomy and ileoanal anastomosis for total colonic aganglionosis[J].Pediatr Surg Int,2016,32(5):477-482.DOI:10.1007/s00383-016-3870-9.
13 Lawal TA,Chatoorgoon K,Collins MH,et al.Redo pull-through in Hirschprung’s disease for obstructive symptoms due to residual aganglionosis and transition zone bowel[J].J Pediatr Surg,2011,46(2):342-347.DOI:10.1016/j.jpedsurg.2010.11.014.
14 Sheng Q,Lv Z,Xiao X.Re-operation for Hirschsprung’s disease:experience in 24 patients from China[J].Pediatric Surgery International,2012,28(5):501-506.DOI:10.1007/s00383-012-3062-1.
15 Ming AX,Li L,Diao M,et al.Long term outcomes of laparoscopic-assisted anorectoplasty:a comparison study with posterior sagittal anorectoplasty[J].J Pediatr Surg,2014,49(4):560-563.DOI:10.1016/j.jpedsurg.2013.11.060.
16 彭飞,余东海,王瑛,等.腹腔镜辅助再次手术治疗先天性巨结肠及巨结肠同源病的临床分析[J].中华妇幼临床医学杂志(电子版),2014,10(3):86-89.DOI:10.3877/cma.j.issn.1673-5250.2014.03.021. Peng F,Yu DH,Wang Y,et al.Clinical analysis of laparoscopic-assisted reoperation for Hirschsprung disease and Hirschsprung allied disease[J].Chin J Obstet Gynecol Pediatr (Electronic Edition),2014,10(3):86-89.DOI:10.3877/cma.j.issn.1673-5250.2014.03.021.
17 Jiang M,Li CL,Cao GQ,et al.Laparoscopic redo pull-through for Hirschsprung disease due to innervation disorders[J].J Laparoendosc Adv Surg Tech A,2018,29(3):424-429.DOI:10.1089/lap.2018.05514.
18 Pini-Prato A,Mattioli G,Giunta C,et al.Redo surgery in Hirschsprung disease:what did we learn? Unicentric experience on 70 patients[J].J Pediatr Surg,2010,45(4):747-754.DOI:10.1016/j.jpedsurg.2009.08.001.
相似文献/References:
[1]刘钢高昕刘树立黄柳明王伟邵培侯文英张军李龙.胆道闭锁葛西手术后肝内胆管扩张的治疗与预后分析[J].临床小儿外科杂志,2010,9(03):0.
LIU Gang,GAO Xin,LIU Shu-li,et al.The managements and prognosis of intrahepatic biliary dilatation with biliary atresia after Kasai procedure[J].Journal of Clinical Pediatric Surgery,2010,9(03):0.
[2]潘静,郑永钦,佘锦标,等.胆道闭锁术后肝内胆管囊性扩张的诊治[J].临床小儿外科杂志,2008,7(04):0.
[3]李志富 张泽俊 连松. 儿童手术后肠套叠29例分析[J].临床小儿外科杂志,2011,10(04):308.
[J].Journal of Clinical Pediatric Surgery,2011,10(03):308.
[4]徐万华 杨志林 尹鉴淳 王浩. 有腹股沟区手术史的隐睾患儿诊疗分析[J].临床小儿外科杂志,2012,11(02):103.
[5]潘伟华 施诚仁 吴晔明 王俊. 儿童腹部实体肿瘤术后乳糜腹的处理[J].临床小儿外科杂志,2012,11(04):247.
[J].Journal of Clinical Pediatric Surgery,2012,11(03):247.
[6]仇杰 费忠化 刘宏生. 婴幼儿先心病术后并发纵膈气肿临床分析[J].临床小儿外科杂志,2012,11(04):260.
[J].Journal of Clinical Pediatric Surgery,2012,11(03):260.
[7]舒仕瑜,张智恩,陈功,等.先天性膈疝患儿手术后近期肺功能的临床观察[J].临床小儿外科杂志,2017,16(05):444.
[8]黄文凯,李雪丽,张瑾,等.先天性巨结肠手术后近期并发症的发生率及危险因素分析[J].临床小儿外科杂志,2018,17(02):99.
Huang Wenkai,Li Xueli,Zhang Jin,et al.Prevalence and risk factors of the early complications after surgery of Hirschprung’s disease：a retrospective cohort study.[J].Journal of Clinical Pediatric Surgery,2018,17(03):99.
[9]冉旭东,徐永根,廖健毅,等.非胸腔镜辅助下Ｎｕｓｓ手术治疗儿童漏斗胸的临床研究[J].临床小儿外科杂志,2018,17(04):286.
Ran Xudong,Xu Yonggen,Liao Jianyi,et al.Clinical study of pectus excavatum by nonthoracoscopic assisted Nuss procedure.[J].Journal of Clinical Pediatric Surgery,2018,17(03):286.
[10]何文飞,张红梅,王城,等.基于阴茎发育规律的儿童包皮环切术式探讨[J].临床小儿外科杂志,2018,17(05):358.
He Wenfei,Zhang Hongmei,Wang Cheng,et al.Prospective analysis of selecting penile diameter,circumcision stapler and foreskin cerclage in children.[J].Journal of Clinical Pediatric Surgery,2018,17(03):358.
[11]曾纪晓,徐晓钢.先天性巨结肠诊疗规范化的再思考[J].临床小儿外科杂志,2021,20(03):201.[doi:10.12260/lcxewkzz.2021.03.001]
Zeng Jixiao,Xu Xiaogang.Some focal issues of standardizing the diagnosis and treatment of Hirschsprung’s disease[J].Journal of Clinical Pediatric Surgery,2021,20(03):201.[doi:10.12260/lcxewkzz.2021.03.001]
[12]曾纪晓,徐晓钢,刘斐,等.经脐单孔腹腔镜辅助下Swenson-like巨结肠根治术38例[J].临床小儿外科杂志,2021,20(09):848.[doi:10.12260/lcxewkzz.2021.09.009]
Zeng Jixiao,Xu Xiaogang,Liu Fei,et al.Efficacies of transumbilical laparoendoscopic single-port surgery for Hirschsprung disease in children,a report of 38 cases[J].Journal of Clinical Pediatric Surgery,2021,20(03):848.[doi:10.12260/lcxewkzz.2021.09.009]
备注/Memo
收稿日期:2020-12-04。
基金项目:北京市属医院科研培育项目（编号：PX2020054）
通讯作者:李龙,Email:lilong23@126.com