Hirschsprung씨 병의 임상적 경험

Clinical Experience with Hirschsprung's Disease

남녀의 비는 1.8로 남아가 많았으며, 진단시 나이는 76.9 % 에서 4주 이내 신생아시기에 진단되었다. 임상증상은 복부팽만 84.6 %, 태변 배출지연이 46.1 %, 설사 와 변비가 23.1 % 였다. 무신경절의 범위가 89.7 %에서 직장 및 에스자형 결장에 한정되었으며, 전결장에 침범한 경우가 8 %였다. 69.2 %에서 결장조루술 후 근치적 수술을 시행하였으며, 30.8 %에서 바로 근치적 수술을 시행하였다. 수술 후 6개월 이상 추적은 54 % 였으며, 추적 관찰 환자 중 14.3 %에서 대변 지림을 보였고, 19.0 %에서 변비를 보였다.

The aim of this study is to review our clinical experience with patients with Hirschsprung's disease (HD) Medical records of 39 children who underwent definitive surgery for HD at Inha University Hospital from September 1996 to June 2008 were analyzed by age at presentation, sex, gestational age, birth weight, clinical presentation, diagnostic tools, level of aganglionosis, surgical procedures, postoperative complications, and postoperative bowel function. Twenty-five patients (64.1 %) were males and 14 (35.9 %) were females. Thirty patients (76.9 %) were diagnosed and treated in the neonatal period. The transitional zone was at the rectosigmoid region in 89.7 %. Twenty-seven patients (69 %) were treated by preliminary colostomy or ileostomy. Twenty-four patients had the Duhamel operation, 6 patients anorectal myectomy, and 9 patients had transanal endorectal pull-through (TEP). Five of 9 patients who had the TEP procedure did laparoscopic assistance. Postoperatively, seventeen patients (83 %) passed stool once or more times per day and 3 patients had stool soiling. This study demonstrated that the majority of the patients had good results. To determine which treatment is most effective comparative review by operation method would be required.