How to perform rectal surgery for Hirschsprung's disease?

How to perform rectal surgery for Hirschsprung's disease?

There are two main surgical options for Hirschsprung disease:

1. It is a radical resection of megacolon. The most commonly used one is anal radical resection of megacolon, which is to remove the diseased intestine through the anus without opening the abdomen. The advantages are that there is no wound in the abdomen, the child recovers quickly, there are fewer complications, the hospital stay is short, and the quality of life is significantly improved. Another is laparoscopic radical resection of megacolon. The specific surgical plan should be selected according to the location and severity of the lesion of megacolon in children.

2. The surgical solution for a giant colon is colostomy. In my country, colostomy is generally used for critical conditions, severe intestinal obstruction or intestinal necrosis, and severe conditions. In order to save lives, we should do colostomy. However, foreign scholars usually advocate colostomy immediately after diagnosis.

Our view is that if the obstruction is long-lasting and the dilated intestinal segment has affected the ascending colon or ileocecal region, we usually perform a colostomy first, partially restore the dilated colon to normal, reduce the scope of colectomy, and then perform radical surgery until the time is right. The advantage of this type of colostomy is that it can avoid postoperative malnutrition and developmental disorders, and the scope of colectomy is relatively small.