经脐腹腔镜手术治疗先天性巨结肠的疗效观察

The efficacy of trans-umbilical laparoscopy and conventional laparoscopy in the treatment of Hirschsprung's disease

目的:探讨经脐腹腔镜手术治疗先天性巨结肠的疗效。方法:回顾性分析2013年1月至2017年1月四川省成都市妇女儿童中心医院收治的92例先天性巨结肠患儿的临床资料,将55例接受经脐腹腔镜手术治疗的患儿作为观察组,37例接受常规腹腔镜手术治疗的患儿作为对照组。对比两组患儿的相关手术指标、术后恢复情况以及近期并发症的发生率。结果:两组患儿均顺利完成手术,无中转开腹病例。观察组患儿左半结肠切除术的手术时间明显少于对照组(P<0.05);两组患儿术中出血量、术后胃肠功能恢复时间、术后住院天数比较,差异均无统计学意义(均P>0.05);观察组术后腹胀的发生率显著低于对照组(P<0.05);两组患儿术后近期并发症的比较差异无统计学意义(P>0.05)。结论:经脐腹腔镜手术治疗先天性巨结肠的临床疗效与常规腹腔镜相当,但经脐腹腔镜手术术后腹胀的发生率低,手术瘢痕更隐蔽。

Objective：To compare the efficacy of trans-umbilical laparoscopy and conventional laparoscopic in the treatment of Hirschsprung＇s disease.Methods：The clinical data of ninety-two children with Hirschsprung＇s disease from January 2013 to January 2017 were retrospectively analyzed.Fifty-five children who underwent trans-umbilical laparoscopic surgery were served as group A,and 37 children who underwent conventional laparoscopic surgery were defined as group B.The operation-related indexes,postoperative recovery and the incidence of short-term complications were compared between the two groups.Results：All surgeries were successfully completed,and no conversion to open surgery.The left colon resection operation time of group A was significantly lower than that of group B（P 〈0.05）.No significant differences were found in the intraoperative blood-loss volume,postoperative gastrointestinal function recovery time,and hospital days between the two groups（P〉0.05）.The postoperative abdominal distension rate of group A was 7.27%,which was significantly lower than that of group B（P〈0.05）.There were no significant difference in the incidence of postoperative complications between two groups（P〉0.05）.Conclusion：The clinical efficacy of trans-umbilical laparoscopic surgery for Hirschsprung＇s disease was similar to that of conventional laparoscopic surgery,but the incidence of abdominal distension after trans umbilical laparoscopic surgery was lower,and the scar was more hidden.