possible. Frozen section biopsy was

possible. Frozen section biopsy was not consistently available during the period and level of resection is from a combination of barium studies’ report, visualization of the transition zone and frozen section when available.

All anastomoses are either covered with a caecostomy tube using size 24-26 Foley’s catheter or well lubricated 2-cc syringe inserted into the anus beyond the anastomosis which is removed on the fifth postoperative day. A gentle rectal examination to assess the anastomosis is done on the 10th day unless there is evidence of peritonitis. During follow-up, the parents were asked about the pattern of bowel motion, presence of continuous soiling and straining at defecation. The older children were also asked about rectal sensation as well as soiling.


RESULTS
There were 33 children managed with Swenson operations during the period, of which 28 were males and five were females (M 5.6: F = 1). The median age at presentation was eight months (range three days to 11 years). The clinical presentation in the patients was as shown in Table 1. Chronic constipation and abdominal distension were the commonest presentations. Despite the late presentation a history of delayed passage of meconium in the neonatal period was obtainable in 20 (60.6%) of the patients. All the patients had features of intestinal obstruction on plain abdominal X-rays while one neonate with caecal perforation had free intraperitoneal gas. Barium enema was done on nine patients and classically demonstrated the transition zone.
Fifteen (45.5%) patients had colostomy prior to the pullthrough. Eleven (73.3%) of the colostomies were sited in the sigmoid colon and the remaining four (26.7%) in the right transverse colon. Nine (60%) of the colostomies were divided while six (40%) were loop colostomy. The median age at formation of colostomy was six months (three days to 11 years). Major complications of prolapse and wound breakdown occurred in four (26.7%) and two (13.3%) of the patients with colostomy respectively. A patient had non-functioning stoma because it was sited blindly in an aganglionic segment. This required refashioning of the stoma to a more proximal level. The duration of the colostomy before definitive pull-through varied from one to 18 months with a median duration of four months.

Hasil (Bahasa Indonesia) 1:

mungkin. Bagian beku biopsi itu tidak konsisten tersedia selama periode dan tingkat reseksi dari kombinasi barium studi laporan, visualisasi zona transisi dan bagian beku bila tersedia.Semua anastomoses adalah baik ditutupi dengan tabung caecostomy menggunakan ukuran 24-26 Foley kateter atau jarum suntik 2-cc baik dilumasi yang dimasukkan ke dalam anus luar anastomosis yang akan dihapus pada hari kelima pasca bedah. Pemeriksaan dubur yang lembut untuk menilai anastomosis dilakukan pada hari ke 10 kecuali ada bukti karena peritonitis. Selama tindak lanjut, orangtua diminta tentang pola gerakan usus, kehadiran terus-menerus mengotori dan tegang di buang air besar. Anak-anak juga ditanya tentang sensasi dubur serta mengotori.HASILAda 33 anak dikelola dengan Swenson operasi selama periode, yang 28 laki-laki dan lima perempuan (M 5.6: F = 1). Usia rata-rata di presentasi adalah delapan bulan (kisaran tiga hari untuk 11 tahun). Presentasi klinis pasien adalah seperti yang ditunjukkan dalam tabel 1. Sembelit kronik dan perut distension yang paling umum presentasi. Meskipun presentasi akhir sejarah tertundanya pembahasan meconium pada periode neonatus adalah diperoleh dalam 20 (60.6%) dari pasien. Semua pasien memiliki fitur sumbatan usus polos perut X-Ray sementara satu neonatus yang dikenal dengan caecal gratis intraperitoneal gas. Barium enema dilakukan pada pasien sembilan dan klasik menunjukkan zona transisi. Lima belas pasien (45.5%) punya elektronik sebelum pullthrough. Sebelas (73.3%) dari colostomies diletakkan di kolon sigmoid dan empat tersisa (26,7%) di usus melintang tepat. Sembilan (60%) dari colostomies dibagi sementara enam (40%) yang loop elektronik. Usia rata-rata pada pembentukan elektronik adalah enam bulan (tiga hari ke 11 tahun). Utama komplikasi prolaps dan luka kerusakan terjadi di empat (26,7%) dan dua (13,3%) dari pasien dengan elektronik masing-masing. Pasien telah berfungsi stoma karena itu ini diletakkan secara membabi buta dalam segmen aganglionic. Ini diperlukan dalam mempermudah pembentukan kembali stoma ke tingkat yang lebih proksimal. Durasi elektronik sebelum definitif ROTOBEC bervariasi dari satu sampai 18 bulan dengan durasi rata-rata empat bulan.