腹腔镜辅助改良Soave术治疗成人先天性巨结肠症

Laparoscopic-assisted modified Soave procedures for adult Hirschsprung disease

目的 评价腹腔镜辅助改良Soave术治疗成人先天性巨结肠症（HD）的临床价值.方法 回顾性分析华中科技大学同济医学院附属协和医院2005年3月至2009年12月间行腹腔镜辅助改良Soave术的28例术前诊断为成人HD患者的临床资料.结果 本组28例患者均成功实施了腹腔镜辅助改良Soave术,无中转开腹.手术时间135～185（165±12）min,术中出血量50～250 ml,无一例术中输血.术后病理诊断示：19例符合HD,9例符合先天性巨结肠类缘病.术后直肠肌鞘感染2例,肛门口轻度污粪3例,平均住院时间（17.5±1.0）d.术后随访无排粪失禁及便秘复发.结论 腹腔镜辅助改良Soave术治疗成人HD安全、有效.

Objective To evaluate the clinical value of laparoscopy-assisted modified Soave procedure for Hirschsprung disease in adults.Methods Twenty-eight patients with a preoperative diagnosis of Hirschsprung disease underwent laparoscopy-assisted modified Soave procedure between March 2005 and December 2009.Clinical data were retrospectively analyzed.Results There were no conversions to open surgery.The mean operative time was （165±12） minutes （range：135-185 minutes）.Estimated blood loss ranged from 50 to 250 ml,and no patients required intraoperative blood transfusion.Postoperative pathologic examination showed Hirschsprung diseases in 19 patients and Hirschsprung allied diseases in 9.Only two patients developed rectal cuff infection and three mild seepage.Other patients had no postoperative complications.The mean hospital stay was （17.5±1.0）days.No fecal incontinence or recurrent constipation occurred during follow-up.Conclusion Laparoscopyassisted modified Soave procedure is safe and effective for Hirschsprung disease.