临床小儿外科杂志Issue(1)：46-48,3.DOI:10.3969/j.issn.1671-6353.2016.01.013
杂交经脐单孔腹腔镜直肠内拖出术治疗先天性巨结肠症
Hybrid single-incision laparoscopic endorectal pull-through approaches for Hirschsprung 's dis-ease
摘要
Abstract
Objetive To explore the rate of intraoperative and postoperative complications,cosmetic re-sults and clinical outcomes of Hybrid single-incision laparoscopic endorectal pull-through (H—SILEP)for Hir-schsprung's disease(HD). Methods Between Sep.2011 and Oct.2014,39 patients (26 males and 13 fe-males,with a mean age of 4.2 months)with HD underwent H — SILEP,through umbilical incision inserted two 5.0 mm trocars,then through a stab incision on the left abdominal wall a trocarless 3.0 mm grasping forceps was inserted.Laparoscopic seromuscular leveling biopsies of the colon were obtained.The affected colon and rectum was then mobilized distally beyond the peritoneal reflection,facilitating the subsequent perineal dissec-tion,pull-through,and coloanal anastomosis.Assessed the operative time,blood loss,intraoperative and postop-erative complications,as well as cosmetic results and clinical outcomes.Results 39 cases all successfully im-plemented by H—SILEP,11 patients had transitional zone in the rectum,20 patients in the sigmoid colon and 8 patients in the descending colon.The operative time was 115 ±6 min.There was no major intraoperative compli-cation with insignificant blood loss(5.0 ±1.2)mL.Perianal excoriation was occurred in 10 patients.No anasto-motic leak occurred.Postoperative enterocolitis occurred in 3 patients,which was cured by conventional treat-ment.Follow-up for 6 months to 3 years in all patients showed excellent cosmetic results and there was no recur-rent constipation.Conclusions H—SILEP is feasible,safe and it is technically similar to perform conventional laparoscopic endorectal pull-through (CLEP)for HD,and the cosmetic results compare favorably with single-in-cision laparoscopic endorectal pull-through (SILEP).关键词
腹腔镜/直肠/Hirschsprung 病Key words
Laparoscopes/Rectum/Hirschsprung Disease引用本文复制引用
张茜,曹国庆,汤绍涛,李帅,雷海燕,李康,向先才,熊梦..杂交经脐单孔腹腔镜直肠内拖出术治疗先天性巨结肠症[J].临床小儿外科杂志,2016,(1):46-48,3.基金项目
卫计委公益性行业科研专项基金 （）
