Lu Hang,Tang Jie,Tang Weibing.Research advances on operative timing and preoperative bowel management of classic Hirschsprung disease[J].Journal of Clinical Pediatric Surgery,2024,(04):395-400.[doi:10.3760/cma.j.cn101785-202403060-018]
经典型先天性巨结肠手术时机与术前肠道管理的研究进展
- Title:
- Research advances on operative timing and preoperative bowel management of classic Hirschsprung disease
- Keywords:
- Hirschsprung Disease; Surgical Procedures; Operative; Perioperative Care; Enema Therapy; Bowel Mangement
- 摘要:
- 先天性巨结肠(Hirschsprung disease,HSCR)是小儿常见的排便障碍性疾病之一,以消化道远端肠管缺乏神经节细胞为病理特点,主要治疗方式为手术切除病变肠管。近年来,随着医疗技术和诊疗理念的进步,80%~90%的患儿新生儿期即可明确诊断。但诊断后何时进行根治手术尚存在争议,目前临床上大多采用新生儿期后的延迟手术方案。明确诊断至接受根治手术期间,需要正确、规范的肠道管理,以缓解远端肠道梗阻,维持患儿排便,预防先天性巨结肠相关性小肠结肠炎(Hirschsprung disease-associated enterocolitis,HAEC),同时确保患儿正常营养需求,维持正常生长发育。本文就HSCR根治手术时机以及术前肠道管理的必要性、肠道管理方式及效果的研究进展进行综述。
- Abstract:
- As one of the most common defecation disorders in children,Hirschsprung disease (HSCR) is characterized by an absence of intestinal ganglion cells.Its major treatment is surgical removal of involved intestine.With rapid advancement of medical technology and evolving concepts of diagnosis and therapy in recent years,about 80-90% of patients may be diagnosed during neonatal period.However,timing of pull-through surgery after a definite diagnosis has remained controversial and it is often delayed after neonatal period.Time from diagnosis to pull-through surgery and standardized bowel management are required to relieve distal intestinal obstruction,maintain bowel movements,improve nutrition and prevent an onset of Hirschsprung disease-associated enterocolitis (HAEC).This review focused upon timing of HSCR pull-through surgery,proper preoperative intestinal management and selecting protocols.
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,Branch of Pediatric Surgery,Chinese Medical Association:Expert Consensus on Diagnosing and Treating Hirschsprung’s Disease[J].Chin J Pediatr Surg,2017,38(11):805-815.DOI:10.3760/cma.j.issn.0253-3006.2017.11.002.
[2] 谢华,唐维兵.规范、统一先天性巨结肠分型的建议[J].临床小儿外科杂志,2021,20(3):212-216.DOI:10.12260/lcxewkzz.2021.03.003. Xie H,Tang WB.Unifying the classification of Hirschsprung’s disease[J].J Clin Ped Sur,2021,20(3):212-216.DOI:10.12260/lcxewkzz.2021.03.003.
[3] Kyrklund K,Sloots CEJ,de Blaauw I,et al.ERNICA guidelines for the management of rectosigmoid Hirschsprung’s disease[J].Orphanet J Rare Dis,2020,15(1):164.DOI:10.1186/s13023-020-01362-3.
[4] Keckler SJ,Yang JC,Fraser JD,et al.Contemporary practice patterns in the surgical management of Hirschsprung’s disease[J].J Pediatr Surg,2009,44(6):1257-1260.DOI:10.1016/j.jpedsurg.2009.02.050.
[5] Bradnock TJ,Walker GM.Evolution in the management of Hirs-chsprung’s disease in the UK and Ireland:a national survey of practice revisited[J].Ann R Coll Surg Engl,2011,93(1):34-38.DOI:10.1308/003588410X12771863936846.
[6] Zani A,Eaton S,Morini F,et al.European Paediatric Surgeons’Association survey on the management of Hirschsprung disease[J].Eur J Pediatr Surg,2017,27(1):96-101.DOI:10.1055/s-0036-1593991.
[7] 谢崇,潘伟康,高亚,等.我国大陆地区先天性巨结肠症诊疗情况调查[J].中华小儿外科杂志,2018,39(6):411-418.DOI:10.3760/cma.j.issn.0253-3006.2018.06.003. Xie C,Pan WK,Gao Y,et al.Management of Hirschsprung’s disease in mainland China[J].Chin J Pediatr Surg,2018,39(6):411-418.DOI:10.3760/cma.j.issn.0253-3006.2018.06.003.
[8] 孙小兵,任红霞,陈淑芸,等.经直肠鞘内拖出巨结肠根治术并发症分析[J].中华胃肠外科杂志,2015,18(5):459-462.DOI:10.3760/cma.j.issn.1671-0274.2015.05.015. Sun XB,Ren HX,Chen SY,et al.Complication analysis of endorectal pull-through radical operation for Hirschsprung disease[J].Chin J Gastrointest Surg,2015,18(5):459-462.DOI:10.3760/cma.j.issn.1671-0274.2015.05.015.
[9] Miyano G,Takeda M,Koga H,et al.Hirschsprung’s disease in the laparoscopic transanal pull-through era:implications of age at surgery and technical aspects[J].Pediatr Surg Int,2018,34(2):183-188.DOI:10.1007/s00383-017-4187-z.
[10] Westfal ML,Okiemy O,Chung PHY,et al.Optimal timing for Soave primary pull-through in short-segment Hirschsprung disease:a meta-analysis[J].J Pediatr Surg,2022,57(4):719-725.DOI:10.1016/j.jpedsurg.2021.07.007.
[11] Onishi S,Kaji T,Nakame K,et al.Optimal timing of definitive surgery for Hirschsprung’s disease to achieve better long-term bowel function[J].Surg Today,2022,52(1):92-97.DOI:10.1007/s00595-021-02356-9.
[12] So HB,Schwartz DL,Becker JM,et al.Endorectal "pull-through" without preliminary colostomy in neonates with Hirschsprung’s disease[J].J Pediatr Surg,1980,15(4):470-471.DOI:10.1016/s0022-3468(80)80755-x.
[13] Pierro A,Fasoli L,Kiely EM,et al.Staged pull-through for rectosigmoid Hirschsprung’s disease is not safer than primary pull-through[J].J Pediatr Surg,1997,32(3):505-509.DOI:10.1016/S0022-3468(97)90617-5.
[14] Sulkowski JP,Cooper JN,Congeni A,et al.Single-stage versus multi-stage pull-through for Hirschsprung’s disease:practice trends and outcomes in infants[J].J Pediatr Surg,2014,49(11):1619-1625.DOI:10.1016/j.jpedsurg.2014.06.002.
[15] Zhang YN,Liu ZZ,Li SS,et al.One-stage transanal endorectal pull-through for Hirschsprung disease:experience with 229 neonates[J].Pediatr Surg Int,2022,38(11):1533-1540.DOI:10.1007/s00383-022-05198-9.
[16] V[KG-0.95mm]u[DD (-*2/3]~[DD)] PA,Thien HH,Hiep PN.Transanal one-stage endorectal pull-through for Hirschsprung disease:experiences with 51 newborn patients[J].Pediatr Surg Int,2010,26(6):589-592.DOI:10.1007/s00383-010-2599-0.
[17] Taguchi T,Obata S,Ieiri S.Current status of Hirschsprung’s disease:based on a nationwide survey of Japan[J].Pediatr Surg Int,2017,33(4):497-504.DOI:10.1007/s00383-016-4054-3.
[18] Lu CG,Hou GJ,Liu CY,et al.Single-stage transanal endorectal pull-through procedure for correction of Hirschsprung disease in neonates and nonneonates:a multicenter study[J].J Pediatr Surg,2017,52(7):1102-1107.DOI:10.1016/j.jpedsurg.2017.01.061.
[19] 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(2):99-105.DOI:10.3969/j.issn.1671-6353.2018.02.005. Huang WK,Li XL,Zhang J,et al.Prevalence and risk factors of the early complications after surgery of Hirschsprung’s disease:a retrospective cohort study[J].J Clin Ped Sur,2018,17(2):99-105.DOI:10.3969/j.issn.1671-6353.2018.02.005.
[20] Heuckeroth RO.Hirschsprung disease-integrating basic science and clinical medicine to improve outcomes[J].Nat Rev Gastroenterol Hepatol,2018,15(3):152-167.DOI:10.1038/nrgastro.2017.149.
[21] 张旻中,蔡威,王俊,等.先天性巨结肠术中快速病理检查分级标准对手术的指导意义[J].中华小儿外科杂志,2020,41(3):230-237.DOI:10.3760/cma.j.issn.0253-3006.2020.03.009. Zhang MZ,Cai W,Wang J,et al.Guidance of a pathological grading system of ganglion cells for intraoperative rapid biopsy of Hirschsprung disease for determining surgical margin and predicting bowel function[J].Chin J Pediatr Surg,2020,41(3):230-237.DOI:10.3760/cma.j.issn.0253-3006.2020.03.009.
[22] 王迪,周炳炎,蒙信尧,等.运用年龄别体重Z评分对先天性巨结肠患儿进行术前营养风险评估[J].中华小儿外科杂志,2022,43(9):811-815.DOI:10.3760/cma.j.cn421158-20210610-00295. Wang D,Zhou BY,Meng XY,et al.Screening of malnutrition children with Hirschsprung’s disease using preoperative weight for age Z scores[J].Chin J Pediatr Surg,2022,43(9):811-815.DOI:10.3760/cma.j.cn421158-20210610-00295.
[23] Wessner S,Burjonrappa S.Review of nutritional assessment and clinical outcomes in pediatric surgical patients:does preoperative nutritional assessment impact clinical outcomes?[J].J Pediatr Surg,2014,49(5):823-830.DOI:10.1016/j.jpedsurg.2014.01.006.
[24] Lu CG,Xie H,Li HX,et al.Feasibility and efficacy of home rectal irrigation in neonates and early infancy with Hirschsprung disease[J].Pediatr Surg Int,2019,35(11):1245-1253.DOI:10.1007/s00383-019-04552-8.
[25] Gosain A,Frykman PK,Cowles RA,et al.Guidelines for the diagnosis and management of Hirschsprung-associated enterocolitis[J].Pediatr Surg Int,2017,33(5):517-521.DOI:10.1007/s00383-017-4065-8.
[26] 施诚仁.再谈先天性巨结肠小肠结肠炎的防治[J].临床小儿外科杂志,2019,18(5):348-351.DOI:10.3969/j.issn.1671-6353.2019.05.002. Shi CR.Re-discussion on prevention and treatment of congenital megacolon enterocolitis[J].J Clin Ped Sur,2019,18(5):348-351.DOI:10.3969/j.issn.1671-6353.2019.05.002.
[27] Galymzhan B,Medet K,Vassily L,et al.The correction methods of the intestinal microflora in chronic colonic stasis by siphon enema and probiotics as a means of the Hirschsprung associated enterocolitis prevention[J].Res J Pharm Technol,2020,13(6):2601-2607.DOI:10.5958/0974-360X.2020.00463.1.
[28] Lewit RA,Kuruvilla KP,Fu M,et al.Current understanding of Hirschsprung-associated enterocolitis:pathogenesis,diagnosis and treatment[J].Semin Pediatr Surg,2022,31(2):151162.DOI:10.1016/j.sempedsurg.2022.151162.
[29] Cheng SY,Wang J,Pan WH,et al.Pathologically assessed grade of Hirschsprung-associated enterocolitis in resected colon in children with Hirschsprung’s disease predicts postoperative bowel function[J].J Pediatr Surg,2017,52(11):1776-1781.DOI:10.1016/j.jpedsurg.2017.03.056.[WTBX] [STBX] [WTBZ] [STBZ]
[30] Smith C,Ambartsumyan L,Kapur RP.Surgery,surgical pathology,and postoperative management of patients with Hirschsprung disease[J].Pediatr Dev Pathol,2020,23(1):23-39.DOI:10.1177/1093526619889436.
[31] Nú?ez R,Torres A,Agulla E,et al.Rectal irrigation and bowel decontamination for the prevention of postoperative enterocolitis in Hirschsprung’s disease[J].Cir Pediatr,2007,20(2):96-100.
[32] Marty TL,Seo T,Sullivan JJ,et al.Rectal irrigations for the prevention of postoperative enterocolitis in Hirschsprung’s disease[J].J Pediatr Surg,1995,30(5):652-654.DOI:10.1016/0022-3468(95)90681-9.
[33] 彭先美.先天性巨结肠患儿结肠回流灌洗的研究进展[J].中国实用医药,2020,15(16):194-196.DOI:10.14163/j.cnki.11-5547/r.2020.16.083. Peng XM.Research advances on colonic reflux lavage in children with congenital megacolon[J].China Pract Med,2020,15(16):194-196.DOI:10.14163/j.cnki.11-5547/r.2020.16.083.
[34] Wetherill C,Sutcliffe J.Hirschsprung disease and anorectal malformation[J].Early Hum Dev,2014,90(12):927-932.DOI:10.1016/j.earlhumdev.2014.09.016.
[35] Frykman PK,Short SS.Hirschsprung-associated enterocolitis:prevention and therapy[J].Semin Pediatr Surg,2012,21(4):328-335.DOI:10.1053/j.sempedsurg.2012.07.007.
[36] Gause CD,Krishnaswami S.Management of anorectal malformations and Hirschsprung disease[J].Surg Clin North Am,2022,102(5):695-714.DOI:10.1016/j.suc.2022.07.005.
[37] Huang EY,Tolley EA,Blakely ML,et al.Changes in hospital utilization and management of Hirschsprung disease:analysis using the kids’inpatient database[J].Ann Surg,2013,257(2):371-375.DOI:10.1097/SLA.0b013e31827ee976.
[38] Vieten D,Spicer R.Enterocolitis complicating Hirschsprung’s disease[J].Semin Pediatr Surg,2004,13(4):263-272.DOI:10.1053/j.sempedsurg.2004.10.014.
[39] Mosiello G,Marshall D,Rolle U,et al.Consensus review of best practice of transanal irrigation in children[J].J Pediatr Gastroenterol Nutr,2017,64(3):343-352.DOI:10.1097/MPG.0000000000001483.
[40] Caponcelli E,Meroni M,Brisighelli G,et al.Transanal irrigation (TAI) in the paediatric population:literature review and consensus of an Italian Multicentre Working Group[J].Pediatr Med Chir,2021,43(1):250.DOI:10.4081/pmc.2021.250.
[41] Huber J,Barnhart DC,Liechty S,et al.Characteristics of the contrast enema do not predict an effective bowel management regimen for patients with constipation or fecal incontinence[J].Cureus,2016,8(8):e745.DOI:10.7759/cureus.745.
[42] Anderson J,Furnival RA,Zhang L,et al.A comparison of the efficacy of enema solutions in pediatric emergency department patients[J].J Emerg Med,2019,57(4):461-468.DOI:10.1016/j.jemermed.2019.07.009.
[43] Beltman L,Labib H,Oosterlaan J,et al.Risk factors for complications in patients with Hirschsprung disease while awaiting surgery:beware of bowel perforation[J].J Pediatr Surg,2022,57(11):561-568.DOI:10.1016/j.jpedsurg.2022.02.022.
[44] Montalva L,Cheng LS,Kapur R,et al.Hirschsprung disease[J].Nat Rev Dis Primers,2023,9(1):54.DOI:10.1038/s41572-023-00465-y.
[45] Fang YY,Kang YL,Teng LJ,et al.A qualitative study on the caregiver burden experience in home reflux enema management of infants with congenital megacolon[J].Int J Qual Stud Health Well-being,2024,19(1):2289225.DOI:10.1080/17482631.2023.2289225.
[46] 张金哲.关于排便控制反射的研究[J].中华小儿外科杂志,1999,20(5):309-310.DOI:10.3760/cma.j.issn.0253-3006.1999.05.131. Zhang JZ.Researches of defecation control reflex[J].Chin J Pediatr Surg,1999,20(5):309-310.DOI:10.3760/cma.j.issn.0253-3006.1999.05.131.
[47] 张金哲.洗肠、扩肛、排便训练[J].中华小儿外科杂志,1988,9(3):177-178.DOI:10.3760/cma.j.issn.0253-3006.1988.03.133. Zhang JZ.Intestinal lavage,anal dilation and defecation training[J].Chin J Pediatr Surg,1988,9(3):177-178.DOI:10.3760/cma.j.issn.0253-3006.1988.03.133.
[48] Lin ZX,Lin Y,Bai JX,et al.Outcomes of preoperative anal dilatation for Hirschsprung disease[J].J Pediatr Surg,2021,56(3):483-486.DOI:10.1016/j.jpedsurg.2020.05.008.
[49] de Geus A,Koppen IJN,Flint RB,et al.An update of pharmacological management in children with functional constipation[J].Paediatr Drugs,2023,25(3):343-358.DOI:10.1007/s40272-023-00563-0.
[50] Gordon M,MacDonald JK,Parker CE,et al.Osmotic and stimulant laxatives for the management of childhood constipation[J].Cochrane Database Syst Rev,2016,2016(8):CD009118.DOI:10.1002/14651858.CD009118.pub3.
[51] 张树成,白玉作.儿童便秘的治疗手段及应用指征[J].临床小儿外科杂志,2020,19(1):12-17,25.DOI:10.3969/j.issn.1671-6353.2020.01.003. Zhang SC,Bai YZ.Treatments and indications of pediatric constipation[J].J Clin Ped Sur,2020,19(1):12-17,25.DOI:10.3969/j.issn.1671-6353.2020.01.003.
[52] 崔焌辉,潘治平,金婧,等.长期使用开塞露对排便障碍的影响及可能机制[J].浙江医学,2020,42(11):1131-1134.DOI:10.12056/j.issn.1006-2785.2020.42.11.2020-316. Cui JH,Pan ZP,Jin J,et al.Effect of long-term use of glycerol enema on defecation disorder and its potential mechanism[J].Zhejiang Med J,2020,42(11):1131-1134.DOI:10.12056/j.issn.1006-2785.2020.42.11.2020-316.
[53] 李颀,孔赤寰,张震,等.经肠镜放置减压管后腹腔镜一期根治术治疗长段型先天性巨结肠[J].中华小儿外科杂志,2018,39(12):889-894.DOI:10.3760/cma.j.issn.0253-3006.2018.12.003. Li Q,Kong CH,Zhang Z,et al.Endoscopic placement of decompression tube for long-segment Hirschsprung’s disease[J].Chin J Pediatr Surg,2018,39(12):889-894.DOI:10.3760/cma.j.issn.0253-3006.2018.12.003.
[54] Zhang JS,Kong CH,Li L.Endoscopic decompression with a transanal drainage tube for the treatment of Hirschsprung’s disease in newborns[J].J Laparoendosc Adv Surg Tech A,2021,31(8):959-963.DOI:10.1089/lap.2020.1035.
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[11]陈宏雄,高亚,徐泉,等.微创切口在治疗先天性巨结肠中的应用[J].临床小儿外科杂志,2007,6(04):7.
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[13]方舒,黄招炜,赵晓霞,等.先天性肠闭锁合并巨结肠的诊断与治疗[J].临床小儿外科杂志,2023,22(09):822.[doi:10.3760/cma.j.cn101785-202305044-005]
Fang Shu,Huang Zhaowei,Zhao Xiaoxia,et al.Association of congenital intestinal atresia and Hirschsprung’s disease: five new cases and its diagnosis and treatment[J].Journal of Clinical Pediatric Surgery,2023,22(04):822.[doi:10.3760/cma.j.cn101785-202305044-005]
[14]阿迪拉·阿不都萨拉木,王文静,朱天琦,等.功能性微创理念在先天性巨结肠患儿围手术期应用临床研究[J].临床小儿外科杂志,2024,(01):22.[doi:10.3760/cma.j.cn101785-202310051-005]
Adila Abudusalamu,Wang Wenjing,Zhu Tianqi,et al.Clinical application of functional minimally invasive surgery for Hirschsprung’s disease[J].Journal of Clinical Pediatric Surgery,2024,(04):22.[doi:10.3760/cma.j.cn101785-202310051-005]
[15]刘远梅,黄露,金祝.先天性巨结肠根治手术中直肠肌鞘切除的现状与思考[J].临床小儿外科杂志,2024,(05):401.[doi:10.3760/cma.j.cn101785-202401058-001]
Liu Yuanmei,Huang Lu,Jin Zhu.Current status and reflections on rectal muscular cuff removal in Hirschsprung’s disease[J].Journal of Clinical Pediatric Surgery,2024,(04):401.[doi:10.3760/cma.j.cn101785-202401058-001]
[16]岳铭,杨合英,张宁,等.先天性巨结肠手术后大便失禁生物反馈治疗效果的影响因素分析[J].临床小儿外科杂志,2024,(05):413.[doi:10.3760/cma.j.cn101785-202401056-003]
Yue Ming,Yang Heying,Zhang Ning,et al.Influncing factors of therapeutic efficacy of biofeedback for fecal incontinence after pull-through in Hirschsprung’s disease[J].Journal of Clinical Pediatric Surgery,2024,(04):413.[doi:10.3760/cma.j.cn101785-202401056-003]
[17]牛泽永,牟亚汝,周玉,等.腹腔镜辅助与单纯经肛门Soave术治疗4岁以下常见型先天性巨结肠症的对比研究[J].临床小儿外科杂志,2024,(05):421.[doi:10.3760/cma.j.cn101785-202402002-004]
Niu Zeyong,Mou Yaru,Zhou Yu,et al.A systematic comparative study of laparoscopic-assisted versus transanal Soave alone for common type congenital megacolonus aged from 0 to 4 years[J].Journal of Clinical Pediatric Surgery,2024,(04):421.[doi:10.3760/cma.j.cn101785-202402002-004]
[18]谢川平,严佳虞,陈亚军,等.先天性巨结肠Soave术后远期排便功能不良的危险因素分析[J].临床小儿外科杂志,2024,(05):426.[doi:10.3760/cma.j.cn101785-202304013-005]
Xie Chuanping,Yan Jiayu,Chen Yajun,et al.Risk factors for long-term bowel function outcomes after Soave procedure for Hirschsprung’s disease[J].Journal of Clinical Pediatric Surgery,2024,(04):426.[doi:10.3760/cma.j.cn101785-202304013-005]
[19]黄圆媛,任红霞.先天性巨结肠手术后小肠结肠炎的危险因素分析[J].临床小儿外科杂志,2024,(05):430.[doi:10.3760/cma.j.cn101785-202206036-006]
Huang Yuanyuan,Ren Hongxia.Risk factors of postoperative Hirschsprung-associated enterocolitis[J].Journal of Clinical Pediatric Surgery,2024,(04):430.[doi:10.3760/cma.j.cn101785-202206036-006]
[20]向路苹,付豪,刘远梅.多组学在先天性巨结肠中的应用及研究进展[J].临床小儿外科杂志,2024,(05):434.[doi:10.3760/cma.j.cn101785-202312028-007]
Xiang Luping,Fu Hao,Liu Yuanmei.Applications and research advances of multi-omics for Hirschsprung’s disease[J].Journal of Clinical Pediatric Surgery,2024,(04):434.[doi:10.3760/cma.j.cn101785-202312028-007]
备注/Memo
收稿日期:2023-04-17。
基金项目:国家自然科学基金项目(81801496)
通讯作者:唐维兵,Email:twbcn@njmu.edu.cn