临床小儿外科杂志2024，Vol.23Issue(9)：819-824,6.DOI:10.3760/cma.j.cn101785-202307017-004
经脐单孔与标准三孔腹腔镜辅助先天性巨结肠根治术的临床对比研究
Comparative study of transumbilical single-port laparoscopy versus standard multi-incision laparoscop-ic endorectal pull-through for Hirschsprung's disease in children
摘要
Abstract
Objective To explore the characteristics,safety,feasibility,advantages and disadvantages of transumbilical single-port laparoscopic endorectal pull-through(SPLEP)for Hirschsprung's disease(HD)in children.Methods From June 2018 to June 2020,a total of 80 children of common-segment HD were selected and randomized into two groups of SPLEP(n=40)treated with SPLEP procedure and standard group(n=40)accepted traditional three-port laparoscopic-assisted procedure.All patients were performed by the same surgeon and followed for 36 to 48 months.Operative duration,volume of blood loss,length of resected bowel,pain score,bowel recovery time,hospitalization stay and perioperative complications were recorded.Results SPLEP or three-port laparoscopic-assisted Swenson-like procedure was performed successfully without any conversion into laparotomy.And SPLEP group required no additional Trocar.The baseline profiles of two groups were compara-ble(P＞0.05).Operative duration of SPLEP and standard group was[(127.36±19.21)vs.(119.26±22.55)min],volume of blood loss[(4.67±1.06)vs.(4.20±0.89)mL],length of resected bowel[(28.13±7.93)vs.(27.97±6.87)cm],bowel recovery time[(11.50±4.07)vs.(13.67±5.25)h],pain score[(2.20±0.63)vs.(2.43±0.56)point]and postoperative hospitalization stay[(5.90±0.66)vs.(6.00±0.52)day](P＞0.05).No significant inter-group difference existed in the postoperative incidence of short/in-termediate-term complications(7.5％vs.10％)(P＞0.05).In SPLEP group,there was no visible postoperative umbilical scar and incision satisfaction was superior in standard group[(1±1)vs.(4±1)point](P＜0.05).Conclusions Both SPLEP and traditional three-port laparoscopic-assisted endorectal pull-through are both safe and efficacious for common-segment HD in children.Both short-term and intermediate-term outcomes are satis-factory.And the cosmetic outcomes of SPLEP are better.关键词
Hirschsprung病/外科手术/腹腔镜检查/治疗结果/方案评价/对比研究Key words
Hirschsprung Disease/Surgical Procedures,Operative/Laparoscopy/Treatment Out-come/Program Evaluation/Comparative Study引用本文复制引用
王欣星,曾纪晓,徐晓钢,刘斐,梁子建,兰梦龙,陶波圆..经脐单孔与标准三孔腹腔镜辅助先天性巨结肠根治术的临床对比研究[J].临床小儿外科杂志,2024,23(9):819-824,6.基金项目
国家自然科学基金(82170528) （82170528）
广东省自然科学基金(2022A1515012254) （2022A1515012254）
广州市科技计划市校(院)联合资助项目(202201020612) （院）
广州地区临床特色技术项目(2023C-TS48) （2023C-TS48）
卫生健康技术重点推广项目(XM202403895) National Natural Science Foundation of China(82170528) （XM202403895）
Natural Science Foundation of Guangdong Province(2022A1515012254) （2022A1515012254）
Guangzhou Science & Technology Grant of Municipal University(Institute)Joint Fund(202201020612) （Institute）
Guangzhou Clinical Characteristic Technology Project(2023 C-TS48) （2023 C-TS48）
Key Promotion Project of Health Technology(XM202403895) （XM202403895）
