腹腔镜辅助下Soave根治术治疗长段型先天性巨结肠效果观察

Laparoscopic assisted radical Soave surgery in the treatment of long segment hirschsprung's disease

目的观察长段型先天性巨结肠治疗中腹腔镜辅助下Soave根治术的临床效果。方法采用回顾性分析方法,研究对象为2018年1月至2020年1月廊坊市人民医院收治的70例长段型先天性巨结肠患儿,根据不同治疗方式分为2组,各35例。对照组选用开腹Soave术治疗,研究组选用腹腔镜辅助下Soave根治术治疗。比较2组手术指标(术中出血量、手术时间、肠管切除长度)、术后指标(肠蠕动恢复时间、禁食时间、住院时间)、肛门功能优良率和并发症发生率。结果2组患儿肠管切除长度相比[(31.15±3.36)cm vs.(32.31±4.85)cm],差异无统计学意义(P>0.05)。研究组患儿手术时间、肠蠕动恢复时间、禁食时间及住院时间为(92.47±12.32)min、(24.51±8.44)h、(15.18±5.83)h、(4.53±0.91)d明显短于对照组[(112.36±17.43)min、(35.72±9.16)h、(19.14±5.97)h、(7.04±1.31)d],术中出血量[(25.53±8.24)mL vs.(45.16±12.13)mL]明显低于对照组,差异均有统计学意义(P<0.05)。研究组患儿肛门功能优良率明显高于对照组(91.43%vs.71.43%),并发症发生率明显低于对照组(5.71%vs.28.57%),差异均有统计学意义(P<0.05)。结论腹腔镜辅助下Soave根治术治疗长段型先天性巨结肠临床效果显著,创伤小,可促使患儿肛门功能快速恢复,并减少并发症。

Objective To observe the clinical effect of laparoscopic-assisted Soave radical resection in the treatment of long-segment Hirschsprung disease.Methods Using a retrospective analysis method,the research objects were 70 children with long-segment Hirschsprung's disease admitted to Langfang People's Hospital from January 2018 to January 2020.They were divided into two groups according to different treatment methods,with 35 cases in each group.The control group was treated with open Soave surgery,and the study group was treated with laparoscopic-assisted Soave radical surgery.Compare the two groups of surgical indicators(intraoperative blood loss,operating time,length of bowel resection),postoperative indicators(intestinal motility recovery time,fasting time,hospital stay),the rate of good anal function and the incidence of complications.Results There was no significant difference in the length of bowel resection between the two groups[(31.15±3.36)cm vs.(32.31±4.85)cm,P>0.05].The study group's operation time,bowel movement recovery time,fasting time,and hospital stay were(92.47±12.32)min,(24.51±8.44)h,(15.18±5.83)h,(4.53±0.91)d,which were significantly shorter than those of the control group[(112.36±17.43)min,(35.72±9.16)h,(19.14±5.97)h,(7.04±1.31)d],and the intraoperative blood loss was significantly lower than that of the control group[(25.53±8.24)mL vs.(45.16±12.13)mL],the differences were significant(P<0.05).The excellent and good rate of anal function was significantly higher than that of the control group(91.43%vs.71.43%),the incidence of complications was significantly lower than that of the control group(5.71%vs.28.57%),the differences were significant(P<0.05).Conclusion Laparoscopy-assisted Soave radical resection is effective in treating long-segment Hirschsprung's disease,with less trauma,which can promote rapid recovery of anal function in children and reduce complications.