腹腔镜改良Soave巨结肠根治术后排便功能的随访

A follow-up study of bowel-control after laparoscopic endorectal pull-through (Soave) procedure for Hirschsprung's Disease

目的 评价腹腔镜改良Soave根治术后患儿排便控制情况。方法 自 1999年 5月～2 0 0 1年 9月 ,对 6 4例年龄为 10d～ 1岁的先天性巨结肠患儿行腹腔镜改良Soave巨结肠根治术。术后定期随访患儿 ,平均随访时间为 (2 3.8± 1)个月 ,对患儿大便控制能力、便秘及结肠炎的发生率进行评价。结果 获访 4 3例患儿。大便控制评分正常 (10分 ) 2 2例 ,好 (6～ 9分 ) 18例 ,欠佳 (1～ 5分 )3例 ;1例患儿 (2 .3% )有持续便秘 ;5例 (11.6 % )患儿曾出现结肠炎。结论 应用腹腔镜改良Soave巨结肠根治术治疗新生儿及小婴儿先天性巨结肠 ,术后可获得良好的排便控制功能。

Objective To appraise the bowel movement and anal continence in patients with Hirschsprung's disease (HD) after laparoscopic endorectal pull through (Soave) procedures.Methods From May 1999 to September 2001, 64 patients (aged 10 days to 1 year) with HD underwent laporoscopic endorectal pull through (Soave) procedure. Postoperative follow up included the occurrence of operative related complications such as adhesive obstruction, anastomotic stenosis or fistula, anal continence, constipation or postoperative enterocolitis. Results Forty three patients completed the study with a mean follow up period of 23.76 ±1 month (ranged 9～36 months). The assessment of anal continence was graded as normal, good, and fair according to the previous study of other investigators. Of the 43 patients, 22 ( 51.1% ) were graded as normal, whereas 18( 41.9% ) were as good and 3 fair (7%).One patient ( 2.3% ) developed constipation and 5 patients ( 11.6% ) had postoperative enterocolitis.Conclusion Laparoscopic endorectal pull through (Soave) procedure performed on young infants with Hirschsprung's disease can get a good bowel control outcome.