腹腔镜短肌鞘Soave与Swenson治疗常见型巨结肠的疗效对比研究  

Comparative effectiveness research of laparoscopic Soave with short muscle cuff versus Swenson in the treatment of common megacolon

作　　者：陈伟[1] 陈铨涛 冯晓川[1] CHEN Wei;CHEN Quan-tao;FENG Xiao-chuan(Department of Pediatric Surgery,Affiliated Zhongshan Hospital of Sun Yat-sen University,Zhongshan 528400,China)

机构地区：[1]中山大学附属中山市人民医院小儿外科,广东中山528400

出　　处：《腹腔镜外科杂志》2022年第10期770-773,共4页Journal of Laparoscopic Surgery

摘　　要：目的:对比腹腔镜短肌鞘Soave与Swenson治疗常见型巨结肠的临床疗效。方法:收集2016~2020年收治的44例常见型巨结肠患儿的临床资料,其中腹腔镜短肌鞘Soave组18例(A组),腹腔镜Swenson组26例(B组)。对比两组手术时间、手术出血量、术后进食时间、停留尿管时间、住院时间、术后并发症。门诊随访1年,记录患儿便秘、污粪、小肠结肠炎等并发症,观察阴茎晨勃情况。结果:两组手术时间、手术出血量、进食时间、住院时间差异无统计学意义;两组术后短期排便习惯改变情况差异有统计学意义,排便次数多集中在5~10次/d,排便次数>10次的患儿中,A组8例(44.4%),B组3例(11.5%);≤5次的患儿中,A组2例(11.1%),B组8例(30.8%)。术后两组均未出现切口感染、吻合口漏、吻合口狭窄;但肛周皮炎A组明显多于B组[8(44.4%)vs.4(15.4%),P<0.05],术后两组导尿管留置时间为5 d,尿管拔除后恢复正常排尿。随访过程中,两组便秘、污粪、小肠结肠炎差异均无统计学意义;术后A组中14位家长观察阴茎不自主晨勃情况,其中12例(85.7%)可见晨勃;B组20位家长观察到16例(80%)晨勃;两组比例差异无统计学意义。结论:腹腔镜短肌鞘Soave与Swenson治疗常见型巨结肠均是安全、有效的,治疗效果相近,术后均可恢复正常排便功能,但对骨盆自主神经功能的影响有待进一步长期随访。Objective:To compare the clinical curative effect of laparoscopic Soave with short muscle cuff versus Swenson in the treatment of common megacolon.Methods:A total of 44 children with common megacolon were treated from 2016 to 2020,including 18 cases in the laparoscopic Soave with common megacolon group(group A)and 26 cases in the laparoscopic Swenson group(group B).Operation time,intraoperative blood loss,postoperative feeding time,indwelling catheter time,hospital stay time and postoperative complications were compared between the two groups.The patients were followed up for 1 year,constipation,fecal stains,enterocolitis and morning erection of penis were observed.Results:There were no significant differences in perioperative indexes between the two groups such as operative time,intraoperative blood loss,feeding time and hospital stay.The difference in short-term postoperative d efecation habit between the two groups was statistically significant,and the number of defecation was mostly 5-10 times/d.Among the patients with defecation times>10 times,there were 8 cases(44.4%)in the group A and 3 cases(11.5%)in the group B;among the patients with defecation times≤5 times,there were 2 cases(11.1%)in the group A and 8 cases(30.8%)in the group B.No i ncision infection,anastomotic leakage and anastomotic stenosis were found in the two groups after operation.However,the number of perianal dermatitis in group A was significantly higher than that in group B[8(44.4%)vs.4(15.4%),P<0.05].The catheterization time of the two groups was 5 d after operation,and normal urination was restored after catheter extraction.There were no significant differences in constipation,soiling and enterocolitis between the two groups.After surgery,14 parents in the group A observed involuntary morning erection of penis,of which 12 cases(85.7%)were visible,and 20 parents in the group B observed 16 cases(80%),with similar proportions.Conclusions:Laparoscopic Soave with short muscle cuff and laparoscopic Swenson are both safe and effective in the

关 键 词：巨结肠 腹腔镜检查 儿童 疗效比较研究 

分 类 号：R656.9[医药卫生—外科学]