摘要
目的评价腹腔镜辅助下小儿结肠次全切除术的安全性、可行性。方法分析52例小儿巨结肠同源病患者的临床资料。其中27例行腹腔镜下结肠次全切除术,男12例,女15例,年龄7个月～14岁;25例行开放式腹会阴Soave法结肠次全切除术,男10例,女15例,年龄5个月～16岁。术前常规行钡灌肠、24h延迟拍片、直肠肛管测压及直肠黏膜活检。两种术式会阴部操作相同,均行Soave法直肠结肠全层吻合。比较2种术式的手术时间、术中出血量、腹腔引流量、肠蠕动恢复时间及两组并发症。结果2种术式出血量、术后腹腔引流量差异无显著性(P>0.05);腹腔镜组手术时间长,肠蠕动恢复快(P<0.05);腹腔镜组并发症发生率低于开腹组(P<0.05)。全组无大出血及死亡病例。结论开腹和腹腔镜辅助下小儿结肠次全切除术均较安全、可靠;腹腔镜创伤小,外形美观,但手术时间长。
[Objective] To evaluate the safety and feasibility of laparoscopic-assisted subtotal colectomy for Hirschsprung＇s disease of allied disorder（HAD） in children. [Method] A total of 52 children with HAD undergoing surgical treatment from October 2000 to December 2006 were reviewed. All the patients were divided into laparoscopic surgery group （27 children aged from 7 months to 14 years） and open surgery group （25 children aged from 5 months to 16 years）. Barium enema, delayed film, anal-rectal manometry and rectal mucosal biopsy were carried out before operation. Anastomosis was performed in all the cases with Soave method. The operation time, intraoperative blood loss, abdominal drainage, postoperative stooling time and perioperative complications in laparoscopic surgery group were compared with that in open surgery group. [Result] There was no difference between groups with respect to intraoperative blood loss, abdominal drainage （P 〉0.05）. The operation time was longer in laparoscopic surgery group than open surgery group （P 〈0.05）. But postoperative stooling was earlier in laparoscopic surgery group （P 〈0.05）. There was no severe bleeding or death in two groups. [Conclusion] Both laparoscopic-assisted and open subtotal colectomy are safe and effective surgical methods for Hirschsprung＇s disease of allied disorder. Laparoscopic subtotal colectomy can be performed safely in children with improved cosmesis, but operation time is longer.
出处
《中国内镜杂志》
CSCD
北大核心
2008年第1期30-33,共4页
China Journal of Endoscopy
关键词
巨结肠同源病
腹腔镜
结肠次全切除术
Hirschsprung＇s disease of allied disorder
laparoscopic
subtotal colectomy
