单孔腹腔镜手术治疗Currarino综合征  

Single-port laparoscopic surgery for Currarino syndrome

作　　者：徐晓钢 曾纪晓 刘斐 兰梦龙 陶波圆 梁子建 温俐妮 叶志华 Xiaogang Xu;Jixiao Zeng;Fei Liu;Menglong Lan;Boyuan Tao;Zijian Liang;Lini Wen;Zhihua Ye(Department of Gastrointestinal Surgery,Guangzhou Women and Children′s Medical Center,Guangzhou Medical University,National Children′s Medical Center For South Central Region,Guangzhou 510120,China)

机构地区：[1]国家儿童区域医疗中心(中南),广州医科大学附属妇女儿童医疗中心胃肠外科,广东510120

出　　处：《中华腔镜外科杂志（电子版）》2024年第2期120-124,共5页Chinese Journal of Laparoscopic Surgery(Electronic Edition)

基　　金：国家自然科学基金(82170528);广东省自然科学基金(2022A1515012254);广州市科技计划市校(院)联合资助项目(202201020612);广州市临床特色技术项目(2023C-TS48);广州市卫生健康科技项目(20231A011040);卫生健康技术重点推广项目(XM202403895)。

摘　　要：目的总结单孔腹腔镜手术治疗Currarino综合征的经验及技巧。方法回顾性分析2018年1月至2023年10月广州医科大学附属妇女儿童医疗中心胃肠外科行单孔腹腔镜手术治疗的5例Currarino综合征(均为男性,年龄1~4岁)患儿的临床资料,评价其手术效果,总结手术经验。结果5例患儿均一期完成单孔腹腔镜下骶前肿物切除、结肠拖出吻合术,术中在单孔腹腔镜辅助下完成远端扩张结直肠游离后,经肛门拖出切除,断端封闭送回腹腔,再实施单孔腹腔镜下骶前肿物切除,最后完成结肠直肠吻合。5例均一期完成手术,无需经后矢状入路操作,无需行肠造瘘术,无中转开放或需增加trocar病例。平均手术时间240 min,术后住院时间中位数为9(7~11)d,术后均恢复良好,骶前肿物病理结果3例为成熟性畸胎瘤、1例为皮样囊肿,1例为脂肪瘤。随访6~48个月,无出血、尿潴留、肠梗阻、吻合口漏、伤口愈合不良、便秘复发、肿物复发等并发症,排便次数1~3次/d,1例术后出现轻度污粪1~2次/周,术后腹部均无可视性瘢痕。结论单孔腹腔镜手术治疗Currarino综合征具有直视下操作、创伤小、切口美观、避免后矢状入路等优点,术后短期效果满意。Objective To summarize the experience and techniques of single-port laparoscopic surgery for Currarino syndrome.Methods The clinical data of 5 children with Currarino syndrome(all male,aged 1-4 years)who underwent single-port laparoscopic surgery in the Department of Gastrointestinal Surgery of Women and Children′s Medical Center Affiliated to Guangzhou Medical University from Jan.2018 to Oct.2023 were retrospectively analyzed,and the surgical effect was evaluated and the surgical experience was summarized.Results All the 5 children underwent presacral mass resection and colon pull through in one stage under single-port laparoscopy.During the operation,the distal dilatation of colorectal was completed with the assistance of single-port laparoscopy,then drag out resection through anus,the severed end was closed and returned to the abdominal cavity,and then presacral mass resection under single-port laparoscopy was performed,and finally colorectal anastomosis was completed.All the 5 cases were completed the operation in one stage without posterior sagittal approach or enterostomy,and there was no conversion to open or additional Trocar.The mean operation time was 240min,and the median postoperative hospital stay was 9(7-11)d.All patients recovered well after surgery.Pathological findings of the anterior sacral masses included 3 cases of mature teratoma,1 case of dermoid cyst,and 1 case of lipoma.No complications such as bleeding,urinary retention,intestinal obstruction,anastomotic leakage,poor wound healing,constipation recurrence,and tumor recurrence were observed during 6-48 months follow-up.The frequency of defecation was 1-3 times per day,and 1 case had mild postoperative fecal contamination 1-2 times per week,and there was no visible scar on the abdomen after surgery.Conclusions Single-port laparoscopic surgery for Currarino syndrome has the advantages of direct view operation,less trauma,beautiful incision,avoiding posterior sagittal approach,etc.,and the short-term postoperative results are satisfactory.

关 键 词：CURRARINO综合征 单孔腹腔镜 手术 

分 类 号：R726.5[医药卫生—儿科]