腹腔镜辅助与开腹Soave术治疗小儿先天性巨结肠的疗效分析

Laparoscopy-assisted versus open Soave surgery for Hirschsprung disease in children

目的:探讨腹腔镜辅助Soave术治疗小儿长段型及不能单纯经肛门Soave手术治疗的常见型先天性巨结肠的有效性与安全性。方法:回顾分析62例先天性巨结肠患儿的临床资料,患儿分别行腹腔镜辅助Soave手术(腹腔镜组,n=30)与传统开腹Soave手术(开腹组,n=32)。结果:两组手术时间、单种并发症发生率差异无统计学意义(P>0.05);腹腔镜组术中出血量、术后首次排气排便时间、住院时间、术后并发症总发生率优于开腹组(P<0.05),腹腔镜组住院费用偏高(P<0.05)。结论:腹腔镜辅助Soave手术治疗长段型及不能单纯经肛门Soave手术治疗的常见型先天性巨结肠是安全、有效的。对于常见型巨结肠,可先行经肛门Soave术,必要时选择腹腔镜辅助。

Objective：To investigate the therapeutic effects and safety of laparoscopic-assisted Soave for long-segment type and common type Hirschsprung disease children who cannot accept simple transanal Soave. Methods：A retrospective study was performed on the clinical data of 62 children with Hirschsprung disease. The 62 patients were divided into laparoscopy group（ n = 30） and open group（ n = 32）. Results：There were no significant differences between the two groups in the operative time and postoperative individual complication（ P〉0. 05）. Compared with open group,laparoscopy group was associated with more hospital costs（ P〈0. 05）,but significantly less intraoperative bleeding,shorter intestine peristalsis recovery time and hospital stay and fewer incidence of postoperative total complications（ P〈0. 05）. Conclusions：Laparoscopic-assisted Soave is safe and effective for long-segment type Hirschsprung disease and common type which cannot accept simple transanal Soave in children. First transanal Soave is suggested for the common type Hirschsprung disease,if necessary,laparoscopic-assisted Soave is an alternative.