腹腔镜辅助治疗小儿乙状结肠冗长症的临床应用

Laparoscopy-assisted sigmoidectomy for the treatment of pediatric dolichosigmoid

目的 探讨腹腔镜手术在小儿乙状结肠冗长症治疗中的经验及与开腹手术比较的优越性。方法 对2002-2006年收治的12例乙状结肠冗长症患儿的手术治疗效果进行回顾性分析。结果本组中4例行开腹冗长结肠切除术，1例经肛门直肠拖出冗长结肠切除术，7例经腹腔镜辅助冗长结肠切除术，所有手术均顺利完成。术后随访2个月-2年，2例排便频繁，2～4次／d，6个月后渐恢复正常；10例恢复良好，排便1～2次／d，术前症状均消失。结论 对小儿乙状结肠冗长症提倡先进行保守治疗，对保守治疗无效或症状明显的患儿可实施手术。腹腔镜辅助冗长结肠切除术治疗本病是安全有效的，与开腹手术相比具有较多的优势。

Objective To evaluate laparoscopy-assisted sigmoidectomy for the treatment of pediatric dolichosigmoid. Methods The clinical data of 12 dolichosigmoid children admitted between 2002 and 2006 were analyzed retrospectively. Results Four cases underwent open surgery of colectomy, 1 case did dolichocolon resection by per anum and rectum pull-through procedure, the other 7 cases received laparoscopy-assisted sigmoidectomy. The surgery was successful in all cases and patients recovered smoothly without major complications. All patients were followed-up from 2 months to 2 years. Two patients had 2 to 4 defecations per day within the first 6 months postoperatively, and recovered thereafter. Preoperative symptoms disappeared in all cases. Conclusions Patients with intractable dolichosigmoid should undergo a surgery, and compared with traditional open procedure laparoscopy-assisted sigmoidectomy is safer and less traumatic.