腹腔镜辅助下改良Swenson术治疗先天性巨结肠

Laparoscopic Assisted Modification Swenson's Treatment for Congenital Hirschsprrung's Disease

目的 :介绍腹腔镜辅助下改良Swenson术治疗先天性巨结肠。方法 :从 1999年 10月起 ,应用腹腔镜为 4 2例先天性巨结肠作改良Swenson术。所有病例均在全麻下 ,运用超声刀游离腹腔内病变结肠 ,结合拖出式直肠肛管背侧纵切 ,心形斜吻合术。结果 :全部患者均经腹腔镜辅助成功完成手术 ,平均手术时间 190min(12 0～ 310min) ,术后平均住院 8d(7～ 9d)。随访 3～ 4 8个月 ,无严重并发症 ,排便基本正常。结论 :腹腔镜辅助下改良Swenson治疗先天性巨结肠具有伤口小、痛苦小、恢复快 ,减少术后腹腔内粘连 ,安全可靠 ,值得推广。

Objective:To introduce laparoscopic-assisted modification Swenson's procedure for congenital Hirschsprung's disease. Methods:Since October 1999,42 cases with Hischsprung's disease underwent laproscopy. All cases underwent anesthesia and the pathological colon was mobilzed ultrasonic surgical knife comblined with vertical cut on the back of pull-throgh rectum-anus with the oblique heart-shaped anasiomosis. Results:All cases were operated on successfully. The average operating time was 190 min (range,120～310 min).The mean hospitalization was 8 days after operation(ranger,7～9 days). During the recent follow-up for 3～48 months, there was a normal excretory in the patients without major complication and. Conclusions:Laparoscopic-assisted modification Swenson's treatment for congenital Hirschsprung's disense has smaller incision, less compicalions, quick recovery and reduce postperative intestinal adhesion. So it is safe and reliable.