Hirschsprung 病における直腸前壁吻合部の高さに関する検討

概要

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The proper level of the anterior rectal wall in modified Duhamel's procedure was studied and discussed. It is more favorable that remaining aganglionic zone should be as small as possible after radical operation for Hirschsprung's disease. But sympathetic and parasympathetic nerve are vulnerable, when an extensive mobilation of the rectum is attempted between the rectum and posterior urethra. Our study suggests that the level of the bladder neck or P-C line is most favorable for the coloproctostomy in the anterior rectal wall. This level is located in 3.5〜4.0cm in infant and 4.0〜5.0cm in child from the anal opening. When coloproctostomy is performed at this level, a part of the rectal ampulla which plays an important rolo to rectal sensation remains, and postoperative temporary stenosis in anastomotic stoma is avoidable.
日本小児外科学会の論文