腹腔镜辅助根治先天性巨结肠症.docVIP

腹腔镜辅助根治先天性巨结肠症 　　作者：孟尔旺，李 龙，王瑛珣，张 军，曹 源 作者单位：连云港市第一人民医院儿外科，江苏 连云港 222002 　　【摘要】 目的 总结腹腔镜辅助下先天性巨结肠症根治术的手术方法、操作经验及疗效，探讨先天性巨结肠症经肛、非开腹治疗的可行性和安全性。方法 回顾性分析14例先天性巨结肠症患儿的临床资料，14例均实施手术，全麻腹腔镜辅助下游离腹腔内病变结肠，行拖出式直肠肛管吻合术。结果 全部病例Ⅰ期根治均获得成功，平均手术时间105 min，术后平均住院时间6.7天。所有患儿未出现严重并发症，远期效果良好。结论 腹腔镜辅助下长段型先天性巨结肠症根治术手术时间短、肠功能恢复早、切口小、安全可靠，充分体现微创的优越性，值得推广。 　　【关键词】 先天性巨结肠症;外科手术;腹腔镜 　　Laparoscopically assisted radical pull-out operation for Hirschsprung disease 　　MENG Erwang1, LI Long2, WANG Yingxun1, ZHANG Jun2, CAO Yuan1 　　(1. Department of Pediatric Surgery, The First People′s Hospital of Lianyungang, Lianyungang, Jiangsu 　　222002, China; 2. Department of Pediatric Surgery, The Capital Institute of Pediatrics, Beijing 100020) 　　Abstract： Objective To summarize operative methods, efficacy and experience of laparoscopic pull-out for long segment Hirschsprung disease and to discuss the feasibility and reliability of this anal non-abdominal surgery. Methods Clinical data of 14 cases with congenital Hirschsprung disease underwent laparoscopy were analyzed retrospectively. All cases underwent recto-anal anastomosis by pull-out though the rectum and anus after the diseased colon was freed laparoscopically under general anesthesia. Results All the cases were successful for first-stage radical treatment, with an average of 105 min of operation duration and 6.7 days of postoperative hospitalization, with no major complications and with a satisfying prospect. Conclusion Laparoscopically-assisted radical treatment for congenital Hirschsprung disease could reduce the operation time, accelerate recovery of intestinal functions, with smaller incisions and more advantages of minimally invasive surgery over classical surgery. Therefore, this approach is proved to be safe, reliable and worthy of popularization. 　　Key words：Hirschsprung disease; surgical procedures; laparoscopy 　　先天性巨结肠症 (Hirschsprung disease) 是一种较常见的小儿消化道畸形，国内统计资料显示该病发病率为0.26%[1]。我院自2002年开始采用经肛门Soave Ⅰ期拖出根治