经脐腹腔镜结肠肛门拖出术治疗儿童神经节细胞减少症  

Transumbilical laparoscopic pull-through for children with hypoganglionosis

作　　者：韦佳[1] 张文[1] 冯杰雄[1] 翁一珍[1] 魏明发[1] 孙晓毅[1] 李宁[1] 余东海[1] 杨继鑫[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院小儿外科,武汉430022

出　　处：《中华胃肠外科杂志》2011年第10期762-763,共2页Chinese Journal of Gastrointestinal Surgery

摘　　要：目的探讨经脐腹腔镜结肠肛门拖出术用于儿童神经节细胞减少症的治疗效果。方法回顾性分析2009年6月至2010年6月间在华中科技大学同济医学院附属同济医院接受经脐腹腔镜肛门拖出手术的12例神经节细胞减少症患儿的临床资料。结果手术使用特制的弯曲手柄型加长器械进行操作，无一例患儿中转开腹或改行传统腹腔镜手术。术中无腹部血管、肠管、输尿管或输精管损伤．平均手术时间140min．平均术中失血量45ml，平均切除病变肠管长度40cm。术后无吻合口瘘、吻合口狭窄、便秘、污粪、排粪失禁等并发症出现，平均术后住院时间9d。术后1个月复诊时均未见明显手术瘢痕。术后经10～22（中位时间16）个月的随访，无一例复发。结论经脐腹腔镜肛门拖出术治疗神经节细胞减少症简单、安全并有效。Objective To investigate the surgical outcomes after on transumbilical laparoscopic pull-through procedure for pediatric hypoganglionosis （HYP）. Methods Twelve children with HYP had received transumbilical laparoscopic pull-through procedure from June 2009 to June 2010. Specially designed curved and elongated laparoscopic instruments were used during the procedures. All the patients were followed up over 10 months. Data were collected and analyzed. The diagnosis of hypoganglionsis was pathologically confirmed. Results No conversions to laparotomy or traditional laparoscopic surgery were required and there were no damages to the abdominal blood vessels, intestine, ductus deferens, or ureters. The average duration of operation was 140 min. The mean intraoperative blood loss was 45 ml. The mean length of specimen was 40 cm. Postoperatively there were no complications suchas anastomotic leak, anastomotic stricture, constipation, secpage, or fecal in continence. The average hospital stay after surgery was 9 days. During 10 to 22 months of follow-up （median 16 months）, no postoperative recurrence was noticed. No obvious scar was seen 1 months after surgery. Conclusion It is safe and effective for children with hypoganglionosis to undergo transumbilical laparoscopic pull-through procedure.

关 键 词：神经节细胞减少症 腹腔镜手术 经脐 单孔 内镜手术 经胚胎期自然腔道 

分 类 号：R726.5[医药卫生—儿科]