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目的 报道我院 1973～ 1999年对 15 0例先天性巨结肠患儿实施“Z”形吻合术的经验。方法 本组 15 0例 ,其中短段型 17例 ,常见型 10 6例 ,长段型 2 4例 ,全结肠型 3例。 17例术前合并肠炎 ,5例出现巨结肠危象。Ⅰ期根治性手术 133例 ,17例先行结肠或回肠造口 ,Ⅱ期作Z形吻合术 (其中 3例作了Boley手术加作Z形吻合术 )。 结果 无手术死亡 ,近期并发症共 2 5人次 ,无近期并发症的病例 12 5例 ,占 83.3%;远期并发症 14例次 ,无并发症 136例 ,占 90 .7%。结论 结肠 直肠“Z”形吻合术 ,操作简便 ,直肠壶腹宽阔 ,术后不需扩肛 ,排便功能好 ,手术并发症低 ,目前已成为小儿外科医师普遍应用的手术方法。
Objective To report the experience of “Z” anastomosis in 150 children with Hirschsprung’s disease from 1973 to 1999 in our hospital. Methods 150 cases of this group, of which 17 cases of short segments, common 106 cases, long segment 24 cases, 3 cases of colon-type. 17 cases of preoperative colitis, 5 cases of megacolon crisis. Stage Ⅰ radical surgery in 133 cases, 17 cases of pre-colon or ileostomy, Ⅱ for Z-anastomosis (3 cases were made Boley surgery plus Z-anastomosis). Results There was no surgical death. There were 25 recent complications, 125 cases without any complication, accounting for 83.3%. There were 14 cases with long-term complication and 136 cases without complication, accounting for 90.7%. Conclusion Colorectal “Z” anastomosis is simple, easy to operate, wide rectum ampulla, no postoperative anal augmentation, good bowel function and low operative complications. It has become a commonly used surgical method for pediatric surgeons.