腹腔镜辅助下经肛门逐层梯度切除直肠肌鞘改良Soave术治疗小儿先天性巨结肠的效果(1)
[摘要]目的 探討腹腔镜辅助下经肛门逐层梯度切除直肠肌鞘改良Soave术的疗效。方法 选取2015年5月～2019年8月我院收治的100例先天性巨结肠患儿为研究对象，按照随机数字表法分为两组，各50例。观察组实施腹腔镜辅助下经肛门逐层梯度切除直肠肌鞘改良Soave术，对照组实施传统肛门改良Soave术。比较两组结肠切除长度、手术切口长度、手术相关指标(手术时间、术中出血量、肛门排气时间及术后住院时间)、并发症及术后1 d、1周及1个月疼痛情况。结果 观察组结肠切除长度和手术切口长度均短于对照组，观察组手术时间短于对照组，术中出血量少于对照组，肛门排气时间早于对照组，术后住院时间短于对照组，观察组并发症总发生率低于对照组，观察组术后1 d、1周及1个月的疼痛评分均低于对照组，差异有统计学意义(P<0.05)。结论 针对小儿先天性巨结肠，实施腹腔镜辅助下经肛门逐层梯度切除直肠肌鞘改良Soave术，手术创伤小，术后恢复快，并发症少，患儿术后疼痛程度低。
[关键词]腹腔镜;经肛门;逐层梯度切除直肠肌鞘;改良Soave术;小儿;先天性巨结肠
[中图分类号] R726.1 [文献标识码] A [文章编号] 1674-4721(2020)6(b)-0128-04
[Abstract] Objective To investigate the clinical effect of laparoscopic-assisted transanal gradient excision of rectal muscle sheath and modified Soave operation on Hirschsprung′s disease in children. Methods A total of 100 cases with Hirschsprung′s disease admitted in our hospital from May 2015 to August 2019 were divided into two groups according to the random number table method， 50 cases in each group. The observation group received laparoscopic-assisted transanal gradient resection of rectal muscle sheath layer by layer and modified Soave operation， the control group received traditional transanal modified Soave operation. The length of the colon resection， the length of the surgical incision， the surgical-related indicators (surgery time， intraoperative bleeding， exhaust time， postoperative hospital stay)， complications， pain of postoperative 1 day， 1 week， and 1 month were compared between two groups. Results The length of colon resection and incision in the observation group were shorter than those in the control group， the operation time in the observation group was shorter than that in the control group， the intraoperative hemorrhage was less than that in the control group， the anal exhaust time was earlier than that in the control group， the postoperative hospitalization time was shorter than that in the control group， the total proportion of intestinal obstruction， intestinal fistula， infection and anemia in the observation group were lower than those in the control group， the postoperative pain scores of postoperative 1 day， 1 week， and 1 month in the observation group were lower than those in the control group， the differences were all statistically significant (P<0.05). Conclusion For Hirschsprung′s disease in children， laparoscopic assisted transanal gradient excision of rectal muscle sheath layer by layer modified Soave operation has less trauma， rapid postoperative recovery， fewer complications and low postoperative pain in children., 百拇医药(赵景全 张正茂 周鹏)
[关键词]腹腔镜;经肛门;逐层梯度切除直肠肌鞘;改良Soave术;小儿;先天性巨结肠
[中图分类号] R726.1 [文献标识码] A [文章编号] 1674-4721(2020)6(b)-0128-04
[Abstract] Objective To investigate the clinical effect of laparoscopic-assisted transanal gradient excision of rectal muscle sheath and modified Soave operation on Hirschsprung′s disease in children. Methods A total of 100 cases with Hirschsprung′s disease admitted in our hospital from May 2015 to August 2019 were divided into two groups according to the random number table method， 50 cases in each group. The observation group received laparoscopic-assisted transanal gradient resection of rectal muscle sheath layer by layer and modified Soave operation， the control group received traditional transanal modified Soave operation. The length of the colon resection， the length of the surgical incision， the surgical-related indicators (surgery time， intraoperative bleeding， exhaust time， postoperative hospital stay)， complications， pain of postoperative 1 day， 1 week， and 1 month were compared between two groups. Results The length of colon resection and incision in the observation group were shorter than those in the control group， the operation time in the observation group was shorter than that in the control group， the intraoperative hemorrhage was less than that in the control group， the anal exhaust time was earlier than that in the control group， the postoperative hospitalization time was shorter than that in the control group， the total proportion of intestinal obstruction， intestinal fistula， infection and anemia in the observation group were lower than those in the control group， the postoperative pain scores of postoperative 1 day， 1 week， and 1 month in the observation group were lower than those in the control group， the differences were all statistically significant (P<0.05). Conclusion For Hirschsprung′s disease in children， laparoscopic assisted transanal gradient excision of rectal muscle sheath layer by layer modified Soave operation has less trauma， rapid postoperative recovery， fewer complications and low postoperative pain in children., 百拇医药(赵景全 张正茂 周鹏)