腹腔镜辅助经肛门直肠肌鞘结肠拖出术治疗先天性巨结肠的疗效

Effect of laparoscopic-assisted transanal endorectal pull-throughs with muscle sheath in the treatment of Hirschsprung′s disease

目的分析腹腔镜辅助经肛门直肠肌鞘结肠拖出术(Soave)治疗先天性巨结肠患儿的临床疗效。方法选取先天性巨结肠患儿86例,采用随机数表法分为观察组(n=43)和对照组(n=43)。对照组采取经肛门Soave术治疗,观察组采取腹腔镜辅助经肛门Soave术治疗。比较2组的手术情况、术后3个月的肛门功能、术前及术后3个月的生活质量以及并发症发生率。结果观察组的手术时间、住院时间、胃肠功能恢复时间短于对照组,差异有统计学意义(P<0.05);术后3个月,观察组的肛门功能、生活质量评分高于对照组,差异有统计学意义(P<0.05);观察组的并发症发生率为4.65%,低于对照组的20.93%,差异有统计学意义(P<0.05)。结论腹腔镜辅助经肛门Soave术能有效改善先天性巨结肠患儿的肛门功能、胃肠功能,提高患儿生活质量,减少并发症发生。

Objective To analyze the clinical effect of laparoscopic-assisted transanal endorectal pull-throughs with muscle sheath(Soave)in children with Hirschsprung′s disease.Methods A total of 86 children with Hirschsprung′s disease were divided into observation group(n=43)and control group(n=43)by random number table method.The control group was treated with transanal Soave,and the observation group was treated with laparoscopic-assisted transanal Soave.The operation situation,anal function 3 months after surgery,quality of life before and 3 months after surgery as well as the incidence of complications were compared between the two groups.Results The operation time,hospitalization time and gastrointestinal function recovery time of the observation group were significantly shorter than those of the control group(P<0.05);three months after operation,scores of anal function and quality of life in the observation group were significantly higher than those in the control group(P<0.05);the complication rate of the observation group was 4.65%,which was significantly lower than 20.93%of the control group(P<0.05).Conclusion The laparoscopic-assisted transanal Soave can effectively improve the anal and gastrointestinal functions,enhance the quality of life and reduce complications in children with Hirschsprung′s disease.