Hirschsprung病術後の早期合併症及び排便機能 : 特に Rehbein 術式について

概要

論文の詳細を見る
Experience of 14 patients with Hirschsprung's disease underwent definitive operation was reviewed and these early postoperative complications and functional results were analysed. Of these 14 cases, 8 were treated by Rehbein procedure, 3 by low anterior resection with rectal myectomy (L.A.R. with myectomy) and 3 by PEARM procedure, The early postoperative complications encountered in this series were mild anastomotic stricture in 3 of 8 patients of Rehbein procedure and fecal fistula in 1 of 3 patients with PEARM. Functional results were evaluated by clinical course and manometric study. Of 7 cases who had undergone Rehbein procedure, 2 have developed constipation, requiring suppositories or enema. Manometric study has shown that patients with Hirschsprung's disease after Rehbein procedure tend to retain higher resting pressure in the anal canal than normal subject as before operation while the patients after 3 of L.A.R. with myectomy have normal pressure in the anal canal achieving good fuunctional results. Thus, it seemed that an anal stretching is an insufficient procedure for sphincter achalasia remaining after Rehbein procedure suggesting sphincter achalasia should be treated by rectal myectomy.
日本小児外科学会の論文
1982-08-20