This is a clinical review and analysis of 115 cases of Hirchsprung's disease which were diagnosed at the Dept. of General Surgery, Presbyterian Medical center, Chonju, Korea.
@ES The results were as follows;
@EN 1) The male to female ratio was about 4.5 : 1.
2) 84.2% of the patients had short segment aganglionosis limited to the rectum and sigmoid colon. (P<0.005).
3) Long segment aganglionosis affected females(35.3%) more than males(10.9%). (P<0.05).
4) The most common complaints was abdominal distension(92.1%), and followed vomiting(53.9%), constipation(36.5%).
5) In age at times of diagnosis, 47.8% of patients were diagnosed in the first month of life.
6) At the time of diagnosis, 32% of patients presented with enterocolitis and breast fed infants(14.3%) had a lower incidence of enterocolitis than formula fed infants(44.0%). (P<0.05).
7) 60 cases were treated by the definitive operation and the most often employed operation was the Soave-Boley(27 cases), then the Duhamel(11%), anorectal myectomy(8), the Swenson(7) and rectosigmoidectomy with rectal myotomy(7).
8) In comparing results of post-operative complication, there were no significant difference between operations. (the rate of complication was 43% in the Swenson, 54% in the Duhamel, 50% in anorectal myectomy and 43% in rectosigmoidectomy with
rectal
myotomy).
9) Performing the operation before the patient was 12 months of age(47%) was compared with performing it in patients older than 12 months (42%), no statistically significant difference in the incidence of morbidity was found. (P<0.2).
10) In comparing results of a one-stage operation without preliminary colostomy(41%) and a two-stage operation with preliminary colostomy(44%), no statistically significant difference in the incidence of morbidity was found. (P>0.2).
|