临床小儿外科杂志2024，Vol.23Issue(5)：421-425,5.DOI:10.3760/cma.j.cn101785-202402002-004
腹腔镜辅助与单纯经肛门Soave术治疗4岁以下常见型先天性巨结肠症的对比研究
A systematic comparative study of laparoscopic-assisted versus transanal Soave alone for common type congenital megacolonus aged from 0 to 4 years
摘要
Abstract
Objective To conduct a preliminary study of clinical experience of laparoscopic-assisted versus transanal Soave alone for common type of congenital megacolon(Hirschsprung's disease,HSCR)aged from 0 to 4 years.Methods For this retrospective study,128 HSCR children operated from January 2011 to December 2022 with complete data were included.According to surgical approach and age,they were assigned into four groups of laparoscopic-assisted transanal Soave 0～2 years(A,n=37),laparoscopic-assisted transanal Soave 2～4 years(B,n=28),simple transanal Soave 0～2 years(C,n=38)and simple transanal Soave 2～4 years(D,n=25).General profiles,surgery-related parameters,postoperative hospitalization complications and follow-up complications were compared.Results Comparing groups A and C,no statistically significant difference existed in gender,age,weight,intraoperative hemorrhage,postoperative hospitalization time,time to resume eating/drinking,postoperative hospitalization complications or follow-up complications(P＞0.05).Op-eration duration in groups A and C was(108.78±14.26)and(95.13±11.18)min,anal operative duration(36.46±5.32)and(79.08±10.96)min and length of resected diseased intestinal tubes(27.11±4.92)and(23.16±3.37)cm respectively.The differences were statistically significant(P＜0.05).Comparing groups B and D,gender,age,weight,operative duration,intraoperative hemorrhage and time to resume eating/drinking were not statistically significant(P＞0.05).Anal operation time in groups B and D was(45.54±6.98)and(110.20±14.61)min,postoperative hospitalization time(8.14±1.43)and(9.60±1.78)day,length of resected diseased intestinal tubes(31.61±6.81)and(27.40±7.38)cm,postoperative hospitaliza-tion complication rates 0 and 16.0％and follow-up complication rate 21.4％and 48.0％respectively.The differences were statistically significant(P＜0.05).Conclusions For HSCR children aged 0～2 years,no significant difference exists in complication rate between laparoscopic-assisted and transanal Soave alone.Lapa-roscopic-assisted transanal Soave is preferred if there is difficulty in dragging out intestinal tube or difficulty in liberating it.For HSCR children aged 2～4 years,complication rate of transanal surgery alone is higher than that of laparoscopy so that laparoscopy is recommended.关键词
先天性巨结肠/腹腔镜/并发症/外科手术/儿童Key words
Hirschsprung Disease/Laparoscopy/Complications/Surgical Procedures,Operative/Child引用本文复制引用
牛泽永,牟亚汝,周玉,丁奕名,辛鹏鸽,李爱武,王健..腹腔镜辅助与单纯经肛门Soave术治疗4岁以下常见型先天性巨结肠症的对比研究[J].临床小儿外科杂志,2024,23(5):421-425,5.基金项目
山东省自然科学基金面上项目(ZR2022MH276、ZR2021MH334) Shandong Provincial Natural Science Foundation Project(ZR2022MH276 & ZR2021 MH334) （ZR2022MH276、ZR2021MH334）
