临床小儿外科杂志2024，Vol.23Issue(3)：229-233,5.DOI:10.3760/cma.j.cn101785-202211057-005
腹腔镜辅助肛门成形术与改良Peña术治疗肛门闭锁伴直肠前庭瘘的疗效对比分析
Comparative analysis of the efficacy of laparoscopic-assisted anorectoplasty with posterior sagittal ano-rectoplasty for anal atresia and vestibular fistula
摘要
Abstract
Objective To explore the efficacy of laparoscopic-assisted anoplasty(LAARP)and modified semi posterior sagittal anorectoplasty(modified Peña)in children with anal atresia and vestibular fistula(AVF).Methods From April 2012 to September 2021,43 AVF children were retrospectively reviewed.Ac-cording to the specific operative techniques,they were assigned into two groups of LAARP(n=16)and modi-fied Pena(n=27).Age of operation,operative duration,intraoperative volume of blood loss,length of hospital stay and postoperative complications(incision infection/dehiscence,rectum retraction,rectal mucosa eversion,anal stenosis & fistula recurrence)were collected.And postoperative defecation control function was compared between two groups by Lee's clinical score.Results There was no significant differences existed in operative age or hospitalization stay between LAARP and modified Pena groups(P＞0.05).Operative time was longer in LAARP group than that in modified Peña group(P＜0.05).Intraoperative blood loss was lower in LAARP group than that in modified Pena group(P＜0.05).No significant inter-group difference existed in the inci-dence of incision infection/dehiscence or anal stenosis(P＞0.05).Three children developed complicated rec-tal retraction in modified Pena group while no rectal retraction occurred in LAARP group(P＞0.05).The inci-dence of rectal mucosal eversion was higher in LAARP group than that in modified Pena group(P＞0.05).No fistula recurred in neither groups.Postoperative defecation function showed no significant inter-group difference(P＞0.05).Conclusions LAARP is a safe and effective operation for the treatment of AVF,which can re-duce the intraoperative bleeding.The long-term defecation function is the same as modified Pena.However,we should highlight the probability of postoperative rectal mucosal eversion and the increased operating time.关键词
肛门直肠畸形/外科手术/儿童Key words
Anorectal Malformation/Surgical Procedures,Operative/Child引用本文复制引用
王维鳌,祝代威,郑泽兵,刘远梅,金祝,汤成艳,龚元,夏兴容,杜青,黄露..腹腔镜辅助肛门成形术与改良Peña术治疗肛门闭锁伴直肠前庭瘘的疗效对比分析[J].临床小儿外科杂志,2024,23(3):229-233,5.基金项目
国家自然科学基金(82060100) （82060100）
贵州省基础研究项目(黔科合基础ZK-2021-361) National Natural Science Foundation of China(82060100) （黔科合基础ZK-2021-361）
Basic Research Project of Guizhou Province(QKHJC-ZK-2021-361) （QKHJC-ZK-2021-361）
