Laparoscopic colonic mapping of dysganglionosis

• Tipo: Artigo em Revista Científica Internacional
• Data: 2001

Autores

Carvalho JL (Autor) Outra; Campos M (Autor) FMUP; Soares-Oliveira M (Autor) Outra; Estevão-Costa J (Autor) FMUP

Revista

Título: Pediatric Surgery International

Vol. 17

Páginas: 493-495

ISSN: 0179-0358

Editora: Springer Nature

Indexação

ISI Web of Knowledge - 11 Citações

ISI Web of Science

Scopus - 18 Citações

Pubmed / Medline

Classificação Científica

FOS: Ciências médicas e da saúde > Outras ciências médicas

Outras Informações

ID Authenticus: P-000-V4F

DOI: 10.1007/s003830000577

Abstract (EN): Retention of a proximal aganglionic segment or the unrecognized coexistence of other dysganglionoses may jeopardize the definitive surgical treatment of Hirschsprung's disease (HD). To assess the extent of the disease and/or the presence of other dysganglionoses without an additional laparotomy, we developed a laparoscopic-assisted technique to perform colonic full-thickness biopsies. After creation of a pneumoperitoneum, a 5-mm laparoscope is inserted in the supraumbilical area and a working 10/12-mm port is placed in the left iliac fossa. The sigmoid/descending colon is grasped and pulled through the abdominal wall and a full-thickness biopsy done. The same procedure is applied to the transverse and ascending colon. Rectal and colonic biopsy specimens were studied using enzyme histochemical methods. Over the last year, five children aged 7 months to 12 years with dysganglionosis underwent laparoscopic-assisted mapping of the colon. Previous rectal suction biopsies were diagnostic of HD in three patients and suspicious of hypoganglionosis in two. Proximal full-thickness biopsies revealed: normal colon in two cases of HD, coexistent type B intestinal neuronal dysplasia up to the descending colon in the other case of HD; and hypoganglionosis up to the ascending colon in the two patients with suspected hypoganglionosis. The procedures were performed easily, the patients being discharged after 36 to 48 h with no complications. Four children have already undergone pull-through procedures with resection of the affected colon in adhesion-free abdominal cavities and did not develop constipation or enterocolitis. Laparoscopic-assisted mapping of the entire colon is a simple, safe, and effective procedure that may contribute to improving the outcome of intestinal dysganglionosis by better characterization of the disease.

Idioma: Inglês

Tipo (Avaliação Docente): Científica

Nº de páginas: 3