CAJ | 학술논문

目的探讨对儿童顽固性便秘的内镜下左半结肠造瘘置管技术和经造瘘置管的结肠治疗效果.方法共选取4例患儿,经结肠运转时间测定诊断为左半结肠转运功能障碍性便秘.在结肠镜下选取降结肠和乙状结肠交界处为结肠造瘘口,行结肠造瘘置管,并给与灌肠治疗.结果4例患儿均成功行左半结肠造瘘并置管,平均手术时间为34分钟(范围22-40分钟).在12个月随访中,4例均有明显的治疗效果,其中有2例治愈.结论内镜下左半结肠造瘘置管方法简便,创伤小.通过该管灌肠治疗由左半结肠功能障碍所致的顽固性便秘在临床上是有效的.
목적탐토대인동완고성편비적내경하좌반결장조루치관기술화경조루치관적결장치료효과.방법공선취4례환인,경결장운전시간측정진단위좌반결장전운공능장애성편비.재결장경하선취강결장화을상결장교계처위결장조루구,행결장조루치관,병급여관장치료.결과4례환인균성공행좌반결장조루병치관,평균수술시간위34분종(범위22-40분종).재12개월수방중,4례균유명현적치료효과,기중유2례치유.결론내경하좌반결장조루치관방법간편,창상소.통과해관관장치료유좌반결장공능장애소치적완고성편비재림상상시유효적.
Objective This study describes experience with a new minimaly invasive technique which involves percutaneous endoscopic colostomy of the left side of the colon and the curtative effect of enema on children with intractable constipation. Method 4 children with refractory constipation and soiling who had radiographic evidence of distal colonic delay were selected for the procedure. The junction of the descending and the sigmoid colon was identified colonscopicly, and the percutaneous endoscopic colostomy tube, through which antegrade distal colonic enema are administered, was inserted. Result 4 children underment required for the procedure was 34 minutes (22minutes-40 minutes). 4 children were no longer soiling and improvement in quality of life was reported at 12 months’ folow-up. 3 children evaluated at 12 months’ folow-up remain clean and 2 children have removed the tube. Conclusion The distal percutaneous endoscopic colostomy is a simple and minimaly invasive alternative to established methods for delivery of antegrade enema. Clinicaly, it is an effective adjunct for management of constipation in patients with fecal incontinence and distal functional fecal retention.