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末吉 亮
Department School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine Position Assistant Professor |
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| Article types | Original article |
| Language | English |
| Peer review | Peer reviewed |
| Title | 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. |
| Journal | Formal name：Journal of pediatric surgery Abbreviation：J Pediatr Surg ISSN code：15315037/00223468 |
| Domestic / Foregin | Foregin |
| Volume, Issue, Page | 50(12),pp.2041-2043 |
| Author and coauthor | 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 |
| Publication date | 2015/12 |
| Summary | 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 |