摘要
目的探讨经脐单孔腹腔镜辅助下采用Swenson-like巨结肠根治术治疗儿童先天性巨结肠的安全性、可行性。方法回顾性分析广州市妇女儿童医疗中心胃肠外科2018年6月至2019年6月收治的38例先天性巨结肠患者临床资料,术式为单孔腹腔镜辅助下Swenson-like巨结肠根治术。男21例,女17例;平均手术年龄(7±3)个月;短段型8例(21%),常见型18例(47%),长段型11例(29%),全结肠型1例(3%)。采用门诊、电话和互联网随诊了解患者术后情况。结果38例均顺利完成经脐单孔腹腔镜辅助下Swenson-like巨结肠根治术,平均手术时间为(126±21)min,平均切除肠管长度为(24±17)cm,肠功能恢复时间为(15±4)h,住院时间为(6±2)d,术后疼痛评分为(3±1)分;21例男性患者术后均可观察到阴茎不自主勃起。术后随访6~18个月,主要术后并发症为污粪(3例,7.89%)和小肠结肠炎(2例,5.26%),术后脐部无可视性手术瘢痕。结论经脐单孔腹腔镜辅助下Swenson-like巨结肠根治术适用于儿童先天性巨结肠的治疗,近期效果良好,术后外观满意。
Objective To evaluate the safety,efficacy and cosmetic outcomes of transumbilical laparoendoscopic single-port(LESP)surgery(Swenson-like approach)for Hirschsprung disease(HSCR)in children.Methods From June 2018 to June 2019,retrospective analysis was performed for clinical data of 38 HSCR children.There were 27 boys and 11 girls with an average age of(7±3)months.LESP was performed by the same surgeon.And postoperative complications and defecations were assessed through outpatient and telephone or internet follow-ups.Results All of them were successfully managed by LESP(Swenson-like approach)without a conversion into laparotomy.The average operative duration was(126±21)min,intraoperative volume of blood loss(5±1)ml,average length of resection(24±17)cm,recovery time of bowel function(15±4)hours,postoperative hospital stay(6±2)days and postoperative pain score(3±1)points.Twenty-one boys reported involuntary postoperative penile erection.During a postoperative period of 6-18 months,the major complications were fecal stool(7.89%)and enterocolitis(5.26%).There was no occurrence of other complications.Scar was invisible.Conclusion Both safe and efficacious for HSCR,LESP surgery(Swenson-like approach)can completely remove ganglion-free intestinal segment without muscle sheath.Its short-term cosmetic outcomes are excellent.
作者
曾纪晓
徐晓钢
刘斐
兰梦龙
朱德力
陶波圆
Zeng Jixiao;Xu Xiaogang;Liu Fei;Lan Menglong;Zhu Deli;Tao Boyuan(Guangzhou Women&Children's Medical Center,Guangzhou 510120,China)
出处
《临床小儿外科杂志》
CAS
CSCD
2021年第9期848-851,865,共5页
Journal of Clinical Pediatric Surgery
基金
国家自然科学基金(编号:82170528)
广东省自然科学基金(编号:2018A030313570)。
