Adila Abudusalamu,Wang Wenjing,Zhu Tianqi,et al.Clinical application of functional minimally invasive surgery for Hirschsprung’s disease[J].Journal of Clinical Pediatric Surgery,,():22-28.[doi:10.3760/cma.j.cn101785-202310051-005]
Clinical application of functional minimally invasive surgery for Hirschsprung’s disease
- Keywords:
- Hirschsprung’s Disease; Functional Minimally Invasive; Laparoscopic; Surgical Procedures; Operative; Child
- Abstract:
- Objective To explore the feasibility and clinical efficacy of functional minimally invasive (FMI) concept in perioperative management of children with Hirschsprung’s disease (HSCR).Methods From March 2019 to March 2023,the relevant clinical data were retrospectively reviewed for 82 HSCR children undergoing heart-shaped laparoscopic anastomosis.They were assigned into two groups of FMI (n=45) and non-FMI (n=37).The former group was composed of 34 boys and 11 girls with a mean age of (1.31±0.96) years while the latter group had 28 boys and 9 girls with a mean age of (1.16±0.63) years.The differences of initial oral feeding timing,initial time of postoperative defecation,postoperative length of stay,postoperative timing of anal tube extraction,pain assessment and postoperative complications were compared between two groups.The measurement data were expressed as x±s.Independent sample t test was utilized for examining the difference of continuous variables in a normal distribution and Mann-Whitney U test for variables in a abnormal contribution.Categorical variables were compared by Chi-square analysis or Fisher’s exact test.Results In comparison with non-FMI group,FMI group had a significantly shorter time for postoperative removal of anal tube [(9.23±1.47) vs.(11.50±1.91) day,P=0.001].Time to initial postoperative oral feeding [(36.92±19.01) vs.(56.76±17.22)h,P=0.005]was significantly shorter.The incidence of postoperative complications declined markedly (P=0.038).Pain scores at 0/24 h post-operation dropped obviously in FMI group as compared with non-FMI group (P<0.05).Krickenbeck scores of anal function spiked in both groups at Month 6 post-operation and the inter-group difference was statistically significant (P<0.05).Initial time of postoperative defecation [(27.74±13.95) hvs.(28.91±12.61) h,P=0.937],length of hospitalization stay[(11.56±4.18) hvs.(13.19±3.67) day,P=0.473]and hospital expenses [(43 087.23±4 729.14)yuan vs.(62 036.34±3 129.77) yuan,P=0.312]were compared and the differences were not statistically significant.Conclusions Surgical application of FMI concept for HSCR is both efficacious and safe.It may accelerate postoperative recovery,reduce postoperative pain,minimize drainage-related discomforts and lower the occurrence of postoperative complications
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Memo
收稿日期:2023-10-27。
基金项目:国家自然科学基金项目(81401240); 湖北省自然科学基金项目(2022CBF134); 湖北省卫生健康委员会科研基金(WJ2021M107)
通讯作者:杨继鑫,Email:yangjixin0910@126.com