腹腔镜辅助下儿童巨结肠根治术  

Laparoscopic assisted endorectal pull-through for Hirschsprung′s disease in children

作　　者：吴晔明[1] 严志龙[1] 施诚仁[1] 陈其民[1] 徐敏[1] 洪莉[1] 

机构地区：[1]上海第二医科大学附属上海儿童医学中心新华医院儿外科,上海200127

出　　处：《中国微创外科杂志》2002年第1期19-20,F004,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的　介绍腹腔镜辅助下改良Soave′s术治疗儿童先天性巨结肠。　方法　 2 0 0 0年 7月～ 2 0 0 1年 7月 ,应用腹腔镜为 10例儿童先天性巨结肠作改良Soave′s术。患儿年龄 2个月至 10岁 ,体重 3.7～ 39kg。　结果　 8例经腹腔镜顺利完成手术 ,术中出血少、愈合后疤痕不明显。术后 4天进食 ,7例 7天出院 ,1例 12天出院。 7例术后自解大便 ,无吻合口狭窄 ,1例仍有便秘 ,扩肛中。另 2例分别因肥胖和病变段过长手术失败而中转开腹。　结论　 腹腔镜可完成儿童巨结肠根治术的腹腔部分操作 ,创伤小、恢复快、疤痕不明显。但有一定适应证。Objective To introduce laparoscopic- assisted modification Soave′s procedure for congenital Hirschsprung′s disease in children. Methods 10 patients with Hirschsprung′s disease were operated on by a modification Soave′s procedure under laparoscopy from July 2000 to July 2001. The age of the children at surgery ranged from 2 months to 10 years and their body weights were from 3.7 to 39kg. Results Eight of the ten patients went through the surgical procedure successfully using laparoscopy. There was not much bleeding during the procedure. Postoperative hospitalization was 7 days in 7 patients and 12 days in one patient. A child had early postoperative constipation. 7 patients had daily spontaneous bowel movements. Open-operations were performed in 2 patients after laparoscopic procedure failed due to over weight and longsegment disease. Conclusions Laparoscopy can be applied to the abdominal procedure in one-stage Soave′s pull-through for Hirschsprung′s disease in children. The advantages of this procedure include minimal trauma, no obviously scar and quick recovery after operation. But the indications should be well chosen.

关 键 词：腹腔镜术 儿童巨结肠 改良 Soave's术 适应证 

分 类 号：R726.5[医药卫生—儿科]