本院における Hirschsprung 病の治療方針について : 人工肛門造設の適応を中心として

概要

論文の詳細を見る
In general, preliminary decompression of the colon by enterostomy for Hirschsprung's disease is thought to be mandatory in patients with long-segment aganglionosis, in those with prolonged obstruction, in newborns, and in patients with enterocolitis. According to these indications for enterostomy, 16 of 27 patients (59%) treated between 1977 and 1983 underwent enterostomy. However, conservative management is preferred to enterostomy, because of necessity of two or three-stage operations and ugly looking scars resulting from the closure of enterostomy. Therefore, since 1984, "traditional" indications for enterostomy have been discarded. Only 8 of 33 patients (24%) treated between 1984 and 1990 underwent enterostomy. These 33 latter cases were compared to the former 27 cases with regards to the length of aganglionic segments, the incidence of enterocolitis prior to definitive surgery, and somatic growth prior to definitive surgery. No difference was found between the two groups in these regards. These findings led to the conclusion that "traditional" indications for preliminary enterostomy should be reevaluated.
日本小児外科学会の論文
1992-10-20