선천성 거대결장의 수술방법 = Surgical Techniques for Hirschsprung's Disease

다국어 초록 (Multilingual Abstract)

Abonormal distribution of the enteric nerves such as adrenergic, cholinergic and peptidergic nerves may cause the funcitonal obstruction in Hirschsprung's disease (HD). Although the sustained contraction of the aganglionic segment is the main patho-physiology of HD, the etiology and pathogenesis is not throughly understood. The cardinal symptoms of HD are failure of passage of meconium within first 24 hours of life, abdominal distension and vomiting. HD is suspected on the basis of history and clinical findings and the diagnosis is established by radiological examination, anorectal manometry, and histochemical analysis of biopsy specimens. Various surgical techniques for HD have been performed with similar results. The first definitive operation was described by Swenson in 1984, Since then other procedures such as Duhamel and Scave were developed in attempt to avoid injury to the autonomic nerves affecting rectal and urinary continence. Recently new surgical trends such as one-stage pull-though, transanal endorectal pull-through and primary laperoscopic-assisted endorectal pull-through without colostomy are developed.