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目的 报告一种新型I期经肛门巨结肠根治术及其手术效果。方法 15例经组织学检查诊断为直肠乙状结肠型巨结肠患儿均行I期经肛门巨结肠根治术 ,方法为在直肠后壁齿状线上1cm、前壁齿状线上 2～ 3cm切开直肠粘膜 ,向近端游离达腹腔水平后 ,切除腹膜外直肠肌鞘至肛提肌水平 ,残留肌鞘后壁“V”形切除。游离近端结肠 ,拖出正常结肠与肛门斜行吻合。结果 平均手术时间 145min(95～ 2 5 0min) ,平均出血 45ml。无术中和术后并发症。随访 1～ 4个月所有患儿排便 2～ 6次 /d ,无污粪。结论 Ⅰ期经肛门巨结肠根治术安全有效 ,远期效果有待随访
Objective To report a new type I stage anal anastomosis and its operative effect. Methods Fifteen patients with rectal sigmoid colon-type megacolon diagnosed by histological examination underwent an anastomotic radical anastomosis. The method consisted of 1 cm in the rectal wall dentate line and 2 to 3 cm in the anterior wall dentate line Rectal mucosa, to the proximal free intraperitoneal level, the removal of extraperitoneal muscle sheath to the level of levator ani muscle remnant muscular sheath “V” resection. Free proximal colon, pulled out of the normal colon and anal oblique anastomosis. Results The average operation time was 145min (95-250min), mean bleeding was 45ml. No intraoperative and postoperative complications. All patients were followed up for 1 to 4 months, defecation 2 to 6 times / d, no sewage manure. Conclusions Stage I analgesia is safe and effective, and the long-term effect remains to be followed up