スエヨシ　リヨウ   末吉　亮    所属   医学部 医学科（東京女子医科大学病院）    職種   講師
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Rectal mucosal dissection commencing directly on the anorectal line versus commencing above the dentate line in laparoscopy-assisted transanal pull-through for Hirschsprung's disease: Prospective medium-term follow-up.
掲載誌名	正式名：Journal of pediatric surgery 略　 称：J Pediatr Surg ISSNコード：15315037/00223468
掲載区分	国外
巻・号・頁	50(12),pp.2041-2043
著者・共著者	Miyano Go, Koga Hiroyuki, Okawada Manabu, Doi Takashi, Sueyoshi Ryo, Nakamura Hiroki, Seo Shogo, Ochi Takanori, Yamada Susumu, Imaizumi Takaaki, Lane Geoffrey J, Okazaki Tadaharu, Urao Masahiko, Yamataka Atsuyuki
発行年月	2015/12
概要	BACKGROUND:In 2007, we began using the anorectal line (ARL) as the landmark for commencing rectal mucosal dissection (RMD) instead of the dentate line (DL) during laparoscopy-assisted transanal pull-through (L-TAPT) for Hirschsprung's disease (HD). We conducted a medium-term prospective comparison of postoperative fecal continence (POFC) between DL and ARL cases to follow our short-term study.METHODS:POFC is assessed by scoring frequency of motions, severity of staining, severity of perianal erosions, anal shape, requirement for medications, sensation of rectal fullness, and ability to distinguish flatus from stool on a scale of 0 to 2 (maximum: 14).RESULTS:Patient demographics were similar for ARL (2007-2014: n=33) and DL (1997-2006: n=41). There were no intraoperative complications and 2 cases of postoperative colitis in both ARL (6.1%) and DL (4.9%). Mean annual medium-term POFC scores for the 4-7 term of this study were consistently better in ARL: 9.7±1.4*, 10.1±1.6*, 10.6±1.6, and 11.3±1.4* in ARL and 8.6±1.5, 9.1±1.6, 9.8±1.9, 10.0±1.6 in DL (*: p<0.05).CONCLUSIONS:Medium-term POFC is better when the ARL is used as the landmark for RMD during L-TAPT for HD.
DOI	10.1016/j.jpedsurg.2015.08.022
PMID	26386879