腹腔镜辅助Rehbein手术治疗成人先天性巨结肠3例报告

Laparoscopic assisted Rehbein operation in treatment of Hirschsprung disease in adults:with a report of 3 cases

目的:探讨腹腔镜辅助Rehbein手术治疗成人先天性巨结肠的难点及对策。方法:回顾分析采用腹腔镜辅助Rehbein手术治疗成人先天性巨结肠3例患者的临床资料。结果:3例患者均取得较满意的疗效。结论:腹腔镜Rehbein手术更适合治疗成人巨结肠;手术最大的难点是患者结肠常有广泛严重的扩张,明显地增加了手术暴露及操作难度,应根据患者病情采取相应的措施。

Objective：To investigate the difficulty and strategy of laparoscopic assisted Rehbein operation in treatment of Hirschsprung disease （HD） in adults.Methods：The clinical data of 3 adults with HD who underwent laparoscopic assisted Rehbein operation from Sep.2006 to Aug.2009 were retrospectively analyzed.Results：Three patients underwent the operations successfully without conversion to open procedure.There were no intraoperative complications.There were no early postoperative complications such as anastomotic leakage.The overall functional outcome was good in all cases with no soiling,stool incontinence,or constipation at a follow-up period of 6-12 months.Conclusions：Laparoscopic Rehbein operation is more appropriate for HD in adults.Generally and prominently dilated colon of the patients with long segment aganglionosis increased difficulty of laparoscopic exposure and operation.Homologus measure should be taken according to patients＇ condition.