腹腔镜下行Soave根治术治疗先天性巨结肠患儿的疗效评估  

Efficacy evaluation of laparoscopic-assisted Soave radical operation in the treatment of children with congenital megacolon

作　　者：董琦[1] 孙为增[1] 王玉芸[1] 张京[1] DONG Qi;SUN Wei-zeng;WANG Yu-yun;ZHANG Jing(Department of Pediatric Surgery,Hainan General Hospital,Haikou 570013,China)

机构地区：[1]海南省人民医院小儿外科,海口570013

出　　处：《上海交通大学学报（医学版）》2018年第7期841-844,共4页Journal of Shanghai Jiao tong University:Medical Science

基　　金：海南省自然科学基金(817309)~~

摘　　要：目的·研究腹腔镜辅助下的Soave根治术在先天性巨结肠患儿中的应用及治疗效果。方法·收集2012年3月—2015年9月于海南省人民医院行腹腔镜辅助下Soave根治术的148例先天性巨结肠患儿的临床资料,回顾性分析患儿的手术时间、术中出血量、住院期间并发症和随访期间并发症。结果·148例患儿均顺利完成腹腔镜手术。平均手术时间为(121.66±22.98)min,术中平均出血量为(4.86±0.66)m L。患儿住院期间并发症发生率为8.10%,无腹腔出血和吻合口漏等近期并发症。术后随访24个月中,1例患儿于术后6个月出现吻合口狭窄,扩肛治疗后痊愈;患儿术后3个月内大便呈糊状,6~12个月后基本正常,排便功能优良率为97.97%;患儿腹胀、便秘等临床症状均消失。结论·腹腔镜辅助下行Soave根治术治疗先天性巨结肠患儿安全有效、并发症少,患儿术后恢复快,具有良好的近期和远期临床疗效。Objective·To evaluate the clinical efficacy of laparoscopic-assisted Soave radical operation in the treatment of children with congenital megacolon.Methods·The clinical datum of 148 pediatric patients with congenital megacolon who had underwent laparoscopic-assisted Soave radical operation in Hainan General Hospital from Mar.2012 to Sept.2015 were collected.Operation time,blood volume lost during the operation,complication incidence during the hospitalization and follow-up period were analyzed,retrospectively.Results·All 148 patients were finished the surgery successfully.Operation time was（121.66±22.98） min,blood volume lost during the operation was（4.86±0.66） m L.During the hospitalization,the incidence of complications was 8.10%.There were no short-term complications observed on abdominal bleeding and anastomotic leakage.The patients were followed up for 24 months,there was one patient with anastomotic stoma stenosis at the 6 months after the operation,who recovered after the treatment of anal dilation.All the pediatric patients′ stool were mushy within 3 months after the operation,and they recovered to normal at the 6-12 months.The excellent rate of defecation function was 97.97%.There were no symptoms of bloated abdomen and astriction for all the patients during the follow-up period.Conclusion·Laparoscopic-assisted Soave radical operation is effective and safe for the treatment of children with congenital megacolon,with few complications,quick recovery,good short-term and long-term clinical effect.

关 键 词：先天性巨结肠 腹腔镜 SOAVE根治术 临床疗效 

分 类 号：R726.5[医药卫生—儿科]