腹腔镜辅助下经肛门巨结肠根治术对先天性巨结肠患儿术后肛门功能和炎症反应的影响

Effects of laparoscopy assisted transanal radical surgery on postoperative anal function and inflammatory response in children with Hirschsprung’s disease

目的:分析腹腔镜辅助下经肛门巨结肠根治术对先天性巨结肠(HSCR)患儿术后肛门功能和炎症反应的影响。方法:收集2013年1月至2018年1月湖北省十堰市太和医院收治的107例HSCR患儿,按手术方式不同分为A组(腹腔镜辅助下经肛门巨结肠根治术,n=57)和B组(常规经肛门Soave术,n=50)。比较两组一般手术情况、术后肛门功能、炎症反应指标及并发症发生率。结果:两组手术时间、麻醉时间及切除肠管长度比较,差异无统计学意义(P>0.05)。A组出血量和排便频次少于B组,住院时间短于B组,Krickenbeck评分显著高于B组,术后3h、12h、24h的C反应蛋白(CRP)水平及并发症发生率显著低于B组(均P<0.05)。结论:腹腔镜辅助下经肛门巨结肠根治术治疗HSCR更利于患儿肛门功能改善,能减轻炎症反应,减少并发症发生,值得临床推广。

Objective:To analyze the effects of laparoscopy assisted transanal radical surgery on postoperative anal function and inflammatory response in children with Hirschsprung’s disease(HSCR).Methods:A total of 107 children with HSCR in our hospital from January 2013 to January 2018 were selected,and divided into group A(57 patients treated with laparoscopy assisted transanal radical surgery)and group B(50 patients treated with conventional surgery).The general conditions of surgery,postoperative anal function,the level of inflammatory response and the incidence of complications was compared.Results:There was no significant difference in the operation time,anesthesia time and the length of removed intestine between the two groups(P>0.05).The blood loss volume,hospital days,defecation frequency,and the level of C-reactive protein(CRP)at 3h,12h and 24h postoperation as well as the incidence of complications in group A were lower than those in group B,while Krickenbeck score was significantly higher(P<0.05).Conclusion:Laparoscopy assisted transanal radical surgery for HSCR could improve anal function,attenuate inflammatory response and reduce the incidence of complications.