Early definitive surgery for total colon aganglionosis: Duhamel procedure with right colon patch graft using GIA stapler

Iwao, Yasuhisa; Obata, Koshiro; Kohi, Minoru

doi:10.1007/bf00497842

Cited by 4 publications

(3 citation statements)

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“…remains to be demonstrated. We previously reported a case with TCA in whom we created an ileostomy 17 cm to the anal side of the transition (17). Although the patient could be managed with oral feeding and passed semisolid stool from the ileostomy, mild enteritis probably due to bowel stagnation originating in the too long agan-Yamagiwa I et al glionic segment occurred dllring the ileostomy period.…”

Section: Discussionmentioning

confidence: 99%

“…Ta eliminate such complications, Kimura et al performed a colonic patch graft technique consisting of a 3 staged procedure: 1) an ileostomy at the distal end of the ganglionic ileum; 2) creation of a longitudinal side-to-side ileocolostomy between the ganglionic ileum and the aganglionic ascending colon; and 3) a definitive puIl-through operation (8). Although Kimura's operation has been widely accepted as the treatment for TCA as weIl as Martin's procedure (10,17), it is very complicated to perform and there is a possibility ofunpredictable disadvantages due to the severed vascular pedicle of the ascending colon.…”

Section: Discussionmentioning

confidence: 99%

“…• Schlüsselwörter: Totale Kolon-und Dünndarmaganglionose-lIeostoma im Übergangssegment Introduction Although a number of operative procedures have been proposedto correct the problem associated with total colon aganglionosis (TeA) (1-3,6-9,12 -14), there have been no reports describing the advantages of an initial diverting ileostomy created at the aganglionic ileum except for our previous case report (17). This report describes 2 infants with TCA involving 50 cm and 10 cm of the ileum in whom an ileostomy was made at the aganglionic portion 5 cm distal to the transition.…”

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confidence: 99%

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An Ileostomy at the Aganglionic Ileum for Total Colon Aganglionosis

Iwao

Obata²,

Okuyama³

et al. 2000

Eur J Pediatr Surg

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For the initial management of total colon aganglionosis (TCA), an ileostomy is usually created at the distal end of the ganglionic bowel, which is associated with profuse diarrhea resulting in a water and electrolyte imbalance as well as malnutrition during the ileostomy period. An ileostomy at the aganglionic ileum several centimeters toward the anal side of the transition for TCA is thus expected to cause bowel retention without any bowel obstruction and to facilitate water reabsorption in the small bowel. We performed this procedure in 2 babies with TCA. The length of the aganglionic ileum was 50 cm and 10 cm, respectively. The ileostomies were made 5 cm distal to the transition at 1 month and 1 day after birth, respectively. Oral feedings were well tolerated, resulting in adequate weight gain and the stools were semisolid during the ileostomy periods. Definitive operations using the Duhamel procedure with a right colon patch graft without the creation of a new ileostomy were successfully performed at 7 and 3 months of age, respectively. The postoperative courses were satisfactory. An ileostomy at the aganglionic ileum appears to be the method of choice as initial management for patients with TCA.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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