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Chinese Journal of Surgery ; (12): 463-466, 2006.
Artículo en Chino | WPRIM | ID: wpr-317132

RESUMEN

<p><b>OBJECTIVE</b>To investigate the relationship between the morphological features of different types of neuronal intestinal malformations (NIM) and their postoperative complications.</p><p><b>METHODS</b>The data of morphological and clinical features of 324 cases with NIM were analyzed retrospectively.</p><p><b>RESULTS</b>In all 324 patients, 210 cases were Hirschsprung's disease (HD), 38 intestinal neuronal dysplasia (IND), 45 mixed HD/IND, 8 hypoganglionosis, 22 combined HD/hypoganglionosis and 1 immaturity of ganglion cells. The percentages of normal neuron in bowel of different NIM were 88.1%, 24.4%, 18.4%, 4/8, 27.7% and 0/1 in HD, HD/IND, IND, hypoganglionosis, HD/hypoganglionosis and immaturity of ganglion cells respectively. There were totally 46 cases complicated with recurrent postoperative enterocolitis (EC). Incidence of recurrent postoperative EC in HD patients was 6.7% while in IND/HD and IND patients was 35.6% and 28.9%, respectively. Incidences of EC in cases with the residual IND margins and with the normal margins were 38.2% and 8.7%, respectively. Incidence of EC in cases with transanal endorectal pull-through procedure and with transabdominal procedure was 18.0% and 8.3%, respectively. Nine cases underwent another procedure because of severe persistent constipation or EC after operation, including 4 cases HD/IND, 1 case IND, 3 cases HD and 1 case HD/hypoganglionosis.</p><p><b>CONCLUSIONS</b>Neuron distribution is inconsistent with pathology of NIM. Postoperative EC are rare in the patients only with isolated HD. Furthermore, margins with residual IND and transanal endorectal pull-through procedure are risk factors to recurrent EC. However, the extension of excision about IND is uncertain and need further study.</p>


Asunto(s)
Adolescente , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Anomalías del Sistema Digestivo , Patología , Cirugía General , Sistema Nervioso Entérico , Anomalías Congénitas , Patología , Enfermedad de Hirschsprung , Patología , Cirugía General , Complicaciones Posoperatorias , Estudios Retrospectivos
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