TRANSANAL
ONE—STAGE RADICAL OPERATION AND OBLIQUE COLOANAL ANASTOMOSIS FOR NEONATES
AND INFANTS WITH HIRSCHSPRUNG’S DISEASE
Xu ZL, Li Y, Li Q, Wang L, An Q, Xing J
Dept. of Pediatric Surgery,
First Hospital Affiliated to Harbin Medical University, Harbin, China
Objective: Using for reference of the advanced technique and methods of abroad
and our country’s in treatment for Hischsprung’s disease, we create a new
type method.
Methods: 8 children aging from 6
weeks to 2 years who all underwent one-stage radical operation and oblique
coloanal anastomosis. Pull-through the rectum above the peritoneal
reflection, then incise the full thickness of rectum circumferentially. The
proximal end drew down and incise the mesocolon at the mean time until a
full-thickness biopsy of the bwel with frozen section analysis found normal
ganglion cells. The distant end is split in the posterior midline about
1.0cm above the dentate line and the anterior midline was 3.0cm above the
dentate line, then the coloanal anastomosis was carried out.
Results: The mean operative
duration was 130 minutes, and an average volume of bleeding was about 30ml.
All children were followed-up 3-10 months, 6 of them have a normal bowel
movement. Early complication included encopresis occurred in 1, because the
split in the posterior midline is near to dentate line who was recovered by
resurturing the sphicter muscle. Posterior sigmoid slight retraction in 1,
who was recovered by conservative treatment.
Conclusion: This procedure is due to
minimally invasive, which has many advantages.