CAJ | 학술논문

先天性巨结肠根治术后,绝大多数患儿可以获得满意的临床效果,但仍有部分患儿因严重并发症需要再次手术.再次手术原因主要包括吻合口狭窄、下拖肠管扭转、残留无神经节细胞症、小肠结肠炎,吻合口漏和各种瘘.再次术前应完善检查并做出正确诊断,根据并发症类型、腹盆腔局部解剖条件和医师的经验选择合理的手术时机和手术方式.遵循基本的外科原则、熟悉解剖结构并注重提高手术技巧,可以减少手术后并发症的发生.
선천성거결장근치술후,절대다수환인가이획득만의적림상효과,단잉유부분환인인엄중병발증수요재차수술.재차수술원인주요포괄문합구협착、하타장관뉴전、잔류무신경절세포증、소장결장염,문합구루화각충루.재차술전응완선검사병주출정학진단,근거병발증류형、복분강국부해부조건화의사적경험선택합리적수술시궤화수술방식.준순기본적외과원칙、숙실해부결구병주중제고수술기교,가이감소수술후병발증적발생.
Most children with Hirschsprung's disease (HD) have a satisfactory outcome after a pull-through operation.However,a small group of patients develop severe postoperative complications,and a reoperation may be necessary.The most common and serious complications after definitive surgery are as follows:anastomotic stricture,a twist of the pull-through segment,retained aganglionosis,HD-associated enterocolitis,anastomotic leak,and fistulae.Using a well-defined treatment algorithm based on the clinical status as well as precise diagnostic workup can end the long suffering of patients with postoperative complications.Pull-through surgery can be safely performed with favorable outcomes after thorough history-taking,meticulous clinical examination,a thoughtful planning,adherence to basic surgical principles and under skillful hands.