Clinical Analysis On Hirschsprung’s Disease In Infant Under 3 Months:a 192 Cases Report

Objective:1. To investigate the clinical diagnostic significance of the calretinin in infants under three months with congenital megacolon.2. To evaluate the efficacy and clinical value of the infants under three months with Hirschsprung’s disease, which underwent trans-anal rectum colon resection and oblique anastomosis.Method:There were 192 patients in our gastrointestinal neonatal surgery hospital from January of 2008 to October of 2014, which were confirmed by the parallel of the anus and rectum oblique resection and anastomosis of the colon or bowel colostomy treatment. Collected the medical records of the preoperative, intraoperative and postoperative data, and follow up those medium-term radical surgery patiens to evaluate the anorectal function and quality of life.Result:1. There were 192 patients with Hirschsprung’s disease,53 cases underwent colonstomy surgery and 139 cases underwent trans-anal rectum colon resection and oblique anastomosis. In the preoperative three auxiliary examination, the positive diagnosis of barium enema examination was 80.1%, a positive diagnosis of anorectal manometry was 92.1%, the positive diagnosis rate of rectal biopsy attract calretinin immunohisto-chemistry was 97.9%.2.66 out of 109 medium-term patients were followed up successfully. Among them, there were two cases of enterocolitis, two cases of defile feces, and non-recurrent constipation, incontinence, anal stenosis, all the male children had penile erectile phenomenon,the growth and development of infants and young children is quite normal. The biochemical tests of 25 patients followed-up were normal. The barium enema were normal in 15 cases. There were 11 cases in the anorectal manometry,10 cases (90.9%) returned to the normal rectoanal inhibitory reflex, one case was no relaxation reflex. The internal anal sphincter and external anal sphincter showed no defects in the endoanal ultrasonography.Conclusion:1. The positive diagnosis rate of calretinin immunohistochemical staining is very high, so it can be used as a golden standard to diagnose the Hirschsprung’s disease for the patients under 3 month before surgical operation.2. Trans-anal rectum colon resection and oblique anastomosis is very appropriate to the patients under 3 month, and worth clinical promotion. Because the design of this surgical approach conforms to the physiological, has the low rate of postoperative complications and satisfaction with the mid-efficacy.