히르슈슈프룽병의 One-stage Transanal Endorectal Pull-through 술식에서 대장조영술의 의의

신만식; 이미정; 김명준; 홍영주; 장혜경; 한석주; 오정탁

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자료유형: 학술저널

저자정보: 신만식 (연세대학교 의과대학 세브란스 어린이병원 소아외과) 이미정 (연세대학교 의과대학 세브란스 어린이병원 소아영상의학과) 김명준 (연세대학교 의과대학 세브란스 어린이병원 소아영상의학과) 홍영주 (연세대학교 의과대학 세브란스 어린이병원 소아외과) 장혜경 (연세대학교 의과대학 세브란스 어린이병원 소아외과) 한석주 (연세대학교 의과대학 세브란스 어린이병원 소아외과) 오정탁 (연세대학교 의과대학 세브란스 어린이병원 소아외과)

저널정보: 대한소아외과학회 Journal of the Korean Association of Pediatric Surgeons : JKAPS Journal of the Korean Association of Pediatric Surgeons : JKAPS 제18권 제2호

발행연도: 2012.1

수록면: 75 - 82 (8page)

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In one-stage transanal endorectal pull-through operation (TERPT) for Hirschsprung disease, preoperative evaluation by contrast enema (CE) is important tool in aspect of planning of surgical procedure as well as diagnosis. This study was to evaluate the significance of CE for identifying the extent of aganglionic bowel. A retrospective analysis was performed in 40 patients who underwent TERPT between 2003 and 2011. The authors reviewed the CE studies and their correlation with pathologic extent of aganglionosis. Total 66 contrast enemas were performed in 40 patients. Twenty patients underwent single CE, but 20 patients required multiple CEs. In single CE group, 17 had clear radiographic transition zone, but 3 had less definite transition zone. In multiple CE group, 17 patients who had equivocal finding in first or second CE had definite radiographic transition zone, but 3 patients of this group had less definite radiographic transition zones. Overall, 34 patients (85%)had clear radiographic transition zone by single or repeated CE. One (2.9%) out of 34 patients with clear radiographic transition zone had discordance between radiographic and pathologic transition zone. In contrast 4 (66.7%) out of 6 patients with equivocal radiographic transition zone had discordance between radiographic and pathologic transition zone. Observation of clear radiographic transition zone is important in preparation of TERPT, and repeated CE is helpful to reduce the discordance between radiographic and pathologic transition zone. Awareness of the possibility of discordance is also important if radiographic transitional zone is not clear.

#Contrast enema #Transanal endorectal pull-through #Hirschsprung's disease

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