腹腔镜辅助治疗婴幼儿先天性巨结肠临床分析

Laparoscopic-assisted Soave's Procedure for Congenital Hirschsprung Disease in Children

目的探讨腹腔镜辅助下治疗婴幼儿先天性巨结肠的临床效果及应用价值。方法回顾分析64例因先天性巨结肠实施根治术的患儿临床资料,按手术方式分为开腹Soave’s法巨结肠根治术和腹腔镜辅助下巨结肠根治术,两种方法会阴部手术操作相同,均行Soave’s法直肠结肠全层吻合。术前均消化道造影,24h延迟拍片,直肠黏膜活检明确诊断。比较两种手术方法的手术时间、术中出血量、肠功能恢复时间、住院时间及并发症。结果腹腔镜组均顺利完成手术,无中转开腹。两组患儿肠功能恢复时间、住院天数及术中出血量有统计学意义(P<0.05);腹腔镜组优于开腹组。结论腹腔镜辅助下治疗先天性巨结肠可充分发挥腹腔镜下探查的优势,减少对肠道的干扰,有效防止肠黏连,创伤少、恢复快、切口美观,安全可行。

Objective To investigate the clinical effect and value of laparoscopic -assisted soave＇s procedure for congenital Hirschsprung Disease in children. Methods The clinic date of 64 patients with congenital Hirschsprung Disease were retrospectively. The patients were divided into open operation soave＇s procedure group and laparoscopic-assisted soave＇s procedure group. The operation procedure is the same in the anal area. Before the operation digestive tract visualization and mucous membrane of rectum biopsy perform to identify final diagnosis. Results In laparoscopic-assisted group the operation was completed successfully without conversion to open surgery, laparoscopicgroup were better than open operation group in terms of bowel function recovery time, blood loss and postoperative hospital stay, which were statistically significant between the two groups （P〈0.05）. Conclusions Laparoscopy assisted soave＇s procedure for congenital Hirschsprung Disease is safe and feasible for children. The recovery time and hospital stay are short after the procedure and the incidence of postoperative complications such as ankylenteron could be prevented because laparoscopy can dimin interference of the gut.