腹腔镜辅助下Soave法治疗长段型巨结肠与开腹手术的临床疗效比较

Comparision of laparoscopic-assisted Soava method with open Soava method in treatment of long-segment type hirschsprung's disease

目的比较腹腔镜辅助下Soave法与常规开腹手术治疗长段型先天性巨结肠(Hirschsprung’s disease,HD)的临床疗效。方法 2011年4月至2015年4月收治长段型巨结肠患儿40例,随机分为腹腔镜结肠切除组20例,开腹结肠切除术组20例,比较两组患者的手术时间、术中出血量、术后住院时间及术后并发症(粘连性肠梗阻、小肠结肠炎)。结果腹腔镜组手术时间短,差异有统计学意义((P<0.05);腹腔镜组的术中出血量比开腹组少,差异有统计学意义(P<0.05);腹腔镜组术后住院时间明显短于开腹手术组,差异有统计学意义(P<0.05);腹腔镜组术后肠粘连发生率低于开腹组,差异有统计学意义(P<0.05);术后小肠结肠炎发生率差异无统计学(P>0.05)。结论腹腔镜辅助下Soave法是治疗HD安全、有效的手术方法,术后恢复快,并发症少。

Objective To compare the clinical efficency of laparoscopic--assisted Soava method with open Soava method in treatment of Long - Segment Type Hirsehsprung＇ s disease. Methods Forty patients were surgically treated for HD from Aprail 2011 to Aprail 2015 ;among them 20 paitients were treated with open Soava method （open group） and an- nother 20 patients received laparoseopic--assisted Soava method （laparoseopic group）. The operation time, the blooding volume, the intestinal functional recovery, postoperative complications （ adhesive ileu, enterocolitis, constipation ） were analyzed. Results The laparoscopic group has less intraoperative blood loss, shorter postoperative hospitalization time, shorter lower incidence of adhesive ileu. （ P 〈 0. 05 ） There were no statistical diffrences in the rate of enterocolitis, con- stipation（P 〉 0.05 ）. Conclusion Laparoscopic--assisted Soava method is a safe and effective method for Hirchs- prung＇ s disease, with postoperative advantages of quick recovery, few complications, and defecation functions similar to open surgery.