腹腔镜下改良短肌鞘Soave术治疗常见型先天性巨结肠术后排便功能及疗效分析  

Analysis of postoperative defecation function and efficacy of laparoscopic modified short muscle sheath Soave procedure in the treatment of common Hirschsprung disease

作　　者：陈伟玉[1] 刘华明[1] 温露华 邓富强[1] CHEN Weiyu;LIU Huaming;WEN Luhua(Department of Pediatric Surgery,Meizhou People's Hospital,Meizhou 514031,China)

机构地区：[1]梅州市人民医院小儿外科,广东梅州514031

出　　处：《腹腔镜外科杂志》2025年第1期49-53,共5页Journal of Laparoscopic Surgery

基　　金：梅州市科技计划项目(2022B13)。

摘　　要：目的:探讨腹腔镜下改良Soave短肌鞘术治疗常见型先天性巨结肠(HD)的临床效果。方法:回顾分析2019年1月至2023年4月收治的60例常见型HD患儿的临床资料,分别行腹腔镜改良Soave短肌鞘术(n=20,改良组)与传统腹腔镜Soave术(n=40,传统组)。对比分析两组围手术期指标、术后早期排便功能、术后并发症及术后6个月肛门排便控制效果。结果:改良组手术时间、肛门操作时间、术后排气时间短于传统组,术中出血量少于传统组,术后白蛋白水平高于传统组,术后1个月每天排便次数少于传统组,术后恢复正常排便时间短于传统组,术后并发症总发生率低于传统组,术后6个月的肛门功能优良率高于传统组,差异均有统计学意义(P<0.05)。结论:与腹腔镜下传统Soave术相比,腹腔镜下改良Soave短肌鞘术治疗小儿常见型HD可减少术后并发症,改善排便功能。Objective:To explore the clinical efficacy of laparoscopic modified Soave short muscle sheath surgery in the treatment of classic-type Hirschsprung disease in children.Methods:A retrospective analysis was conducted,60 children with classic-type Hirschsprung disease admitted from Jan.2019 to Apr.2023 were selected.According to different surgical plans,they were divided into modified Soave short muscle sheath surgery(n=20,improved group)and traditional laparoscopic Soave surgery(n=40,traditional group).Perioperative indicators,early postoperative defecation function,postoperative complications,and anal defecation control at 6 months were analyzed and compared between the two groups.Results:The improved group had a shorter operation time,shorter anal o peration time,less intraoperative blood loss,shorter time to first flatus,and higher postoperative serum albumin value compared to the traditional group,with statistically significant differences;compared with the traditional group,the improved group had a shorter time to achieve normal defecate movements and fewer daily defecation frequency one month after surgery,and the difference was statistically significant(P<0.05).Compared with the traditional group,the overall incidence of postoperative complications was significantly lower in the improved group,the excellent and good rate of anal function in the improved group at 6 months after surgery was higher than that in the traditional group,with statistically significant differences(P<0.05).Conclusions:Compared with traditional Soave surgery,laparoscopic modified short muscle sheath Soave procedure can reduce postoperative complications and achieve better defecation function in children with classic-type Hirschsprung disease.

关 键 词：HIRSCHSPRUNG病 改良Soave短肌鞘术 腹腔镜检查 排便 

分 类 号：R656.9[医药卫生—外科学]