腹腔镜辅助下改良Swenson法治疗先天性巨结肠与开腹手术的临床疗效比较  

Comparison of Iaparoscopic-assisted modified Swenson method with open Swenson method in treatment of Hirschsprung＇s disease

作　　者：於林军[1] 罗春芬[1] 宋代强[1] 刘征吉[1] 周学武[1] 单王永[1] 

机构地区：[1]浙江省台州医院小儿外科,317000

出　　处：《浙江医学》2010年第10期1498-1500,共3页Zhejiang Medical Journal

摘　　要：目的 比较腹腔镜辅助下改良Swenson法与开腹手术治疗先天性巨结肠（HD）的临床疗效.方法 将60例HD患儿分为开腹组（32例）、腹腔镜组（28例）两组,比较两组患者的手术时间、术中出血量、术后禁食时间、术后住院时间及术后并发症.结果 术后禁食时间腹腔镜组为（36±7）h,明显短于开腹手术组（72±6）h,差异有统计学意义（P〈0.01）;腹腔镜组术后住院时间为（7±2）d,明显短于开腹手术组（10±3）d,差异有统计学意义（P〈0.01）;两种手术方式的术后并发症的差异无统计学意义（P〉0.05）;开腹组1例发生切口感染、2例肠粘连肠梗阻,而腹腔镜组未发生粘连肠梗阻.结论 腹腔镜辅助下改良Swenson法是治疗HD安全、有效的手术方法,术后恢复快,并发症少,与开腹手术的术后并发症发生率的差异无统计学意义（P〉0.05）.Objective To compare the clinical efficacy of laparoscopic-assisted modified Swenson method witj open Swenson method in treatment of Hirschsprung＇s disease （HD）. Methods Sixty patients were surgically treated for HD; among them 32 patients were treated with open Swenson method （open group） and 28 received modified Swenson method （laparoscopic group）. Twenty nine patients in open group and 26 in laparoscopy group were followed up for average 2 years, respec- tively. The postoperative fasting time, the length of postoperative hospital stay and complications were analyzed. Results The postoperative fasting time was shorter in laparoscopic group （36±7 h） than in open group （72 ± 6 h） （t =12.77,P 〈0.001）. The length of postoperative hospital stay was shorter in the laparoscopic group （7±2 d） than in the open group （10±3 d） （t=6.713, P 〈0.001）. There were no statistical differences in the rate of postoperative complications between two groups （X2 =0.013, P 〉0.05）. There were 1 case of wound infection and 2 cases of adhesive ileus in open group, while no complications were found in laparo- scopic group. Conclusion Laparescopic-assisted modified Swenson method is a safe and effective surgical modality for Hirschsprung＇s disease, with advantages of quick recovery and few complications.

关 键 词：先天性巨结肠 腹腔镜 开腹手术 

分 类 号：R726.569[医药卫生—儿科]