腹腔镜辅助经肛门Soave术治疗先天性巨结肠的疗效分析OACSTPCD

Objective:To observe the effectiveness of laparoscopic assisted transanal Soave surgery in the treatment of Hirschs-prung disease(HD)in children.Methods:A total of 105 children with HD admitted from Jan.2020 to Dec.2022 were selected and separated into two groups based on different surgical methods.Group A(n=52)underwent transanal Soave surgery,while group B(n=53)underwent laparoscopic assisted transanal Soave surgery.Perioperative indicators,intestinal flora,defecation function,pain media-tors,and complications were compared between the two groups.Results:Compared with group A,group B had longer surgical time and anal canal resection length,shorter anal dissection time and postoperative hospital stay,less intraoperative blood loss,the differences were significant(P＜0.05).After surgery,the levels of Bifidobacterium,Lactobacillus,and Enterococcus faecalis in the two groups were higher than before surgery(P＜0.05),while the level of Escherichia coli was lower than before surgery(P＜0.05),and the levels of Bifidobacterium,Lactobacillus,and Enterococcus faecalis in group B were higher than those in group A(P＜0.05),while the level of Escherichia coli was lower than that in group A(P＜0.05).After operation,the levels of prostaglandin E2,substance P and β-endorphin in two groups were higher than those before operation(P＜0.05),and those in group B were lower than those in group A(P＜0.05).The distinguished achiever ratio of defecation function in group B was higher than that in group A[94.34%(50/53)vs.80.77%(42/52),P＜0.05].The total incidence of postoperative complications in group B was lower than that in group A[5.66%(3/53)vs.19.23%(10/52),P＜0.05].Conclusions:The overall effect of laparoscopic-assisted transanal Soave surgery in the treatment of chil-dren with HD is better than that of transanal Soave surgery,it can promote the recovery of defecation function,reduce the release of pain mediators and the incidence of complications,and has high clinical application value.