[АNORECTAL DYSFUNCTION, OCCURRING AFTER SURGICAL TREATMENT OF HIRSCHPRUNG’S DISEASE AND ITS CORRECTION].

Klinichna khirurgiia Pub Date : 2017-01-01
R Sh Polukhov
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Abstract

Results of examination and treatment of 12 children, operated on in various clinics for Hirschprung’s disease, in whom chronic constipation and other signs of anorectal dysfunction have occurred, were analyzed. In 8 patients Duhamel-Bairov operation was conducted, in 2 – Soave-Lenyushkin operation, and in 2 – Soave-Boley operation. The main cause of postoperative chronic constipation occurrence after Duhamel operation is the colorectal septum preservation. The only one radical method of treatment of this complication is a transanal removal of colorectal septum. The cause of anastomotic narrowing after Soave-Boley operation was absence of myotomy intraoperatively and of bougienage – after it. Elimination of chronic constipation in such patients, using long-standing bougienage and complex conservative treatment. The main cause of chronic constipation and nocturnal encopresis after Soave-Lenyushkin operation was preservation of the tissue excess while doing resection of a large bowel stump and creation of the narrowed ring, looking like a pendent plica. Complete reconvalescence of such patients is possible in transanal method of excision of stenosing ring and conduction of complex treatment.

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[Аnorectal手术治疗和矫正后出现的功能障碍]。
分析了12名儿童的检查和治疗结果,这些儿童在不同的诊所接受了Hirschprung病的手术,其中出现了慢性便秘和其他肛门直肠功能障碍的迹象。8例患者行Duhamel-Bairov手术,2例Soave-Lenyushkin手术,2例Soave-Boley手术。Duhamel手术后发生慢性便秘的主要原因是结肠中隔保留。治疗这种并发症的唯一根治方法是经肛门切除结肠中隔。Soave-Boley手术后吻合口狭窄的原因是术中没有切开肌,术后没有切开肌。消除这类患者的慢性便秘,采用长期布根术和复杂的保守治疗。soeve - lenyushkin手术后慢性便秘和夜间内窥病的主要原因是在切除大肠残端时保留了多余的组织,造成了狭窄的环,看起来像一个悬垂的皱襞。经肛门狭窄环切除及综合治疗可使患者完全康复。
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发文量
21
审稿时长
12 weeks
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