Wang Xinxing,Zeng Jixiao,Xu Xiaogang,et al.Comparative study of transumbilical single-port laparoscopy versus standard multi-incision laparoscopic endorectal pull-through for Hirschsprung’s disease in children[J].Journal of Clinical Pediatric Surgery,,():819-824.[doi:10.3760/cma.j.cn101785-202307017-004]
Comparative study of transumbilical single-port laparoscopy versus standard multi-incision laparoscopic endorectal pull-through for Hirschsprung’s disease in children
- Keywords:
- Hirschsprung Disease; Surgical Procedures; Operative; Laparoscopy; Treatment Outcome; Program Evaluation; Comparative Study
- Abstract:
- Objective To explore the characteristics,safety,feasibility,advantages and disadvantages of transumbilical single-port laparoscopic endorectal pull-through (SPLEP) for Hirschsprungs disease (HD) in children. Methods From June 2018 to June 2020,a total of 80 children of common-segment HD were selected and randomized into two groups of SPLEP (n=40) treated with SPLEP procedure and standard group (n=40) accepted traditional three-port laparoscopic-assisted procedure.All patients were performed by the same surgeon and followed for 36 to 48 months.Operative duration,volume of blood loss,length of resected bowel,pain score,bowel recovery time,hospitalization stay and perioperative complications were recorded. Results SPLEP or three-port laparoscopic-assisted Swenson-like procedure was performed successfully without any conversion into laparotomy.And SPLEP group required no additional Trocar.The baseline profiles of two groups were comparable (P>0.05).Operative duration of SPLEP and standard group was[(127.36±19.21) vs.(119.26±22.55) min],volume of blood loss[(4.67±1.06) vs.(4.20±0.89) mL],length of resected bowel[(28.13±7.93) vs.(27.97±6.87) cm],bowel recovery time[(11.50±4.07) vs.(13.67±5.25) h],pain score[(2.20±0.63) vs.(2.43±0.56) point]and postoperative hospitalization stay[(5.90±0.66) vs.(6.00±0.52) day](P>0.05).No significant inter-group difference existed in the postoperative incidence of short/intermediate-term complications (7.5% vs.10%)(P>0.05).In SPLEP group,there was no visible postoperative umbilical scar and incision satisfaction was superior in standard group[(1±1) vs.(4±1) point](P<0.05). Conclusions Both SPLEP and traditional three-port laparoscopic-assisted endorectal pull-through are both safe and efficacious for common-segment HD in children.Both short-term and intermediate-term outcomes are satisfactory.And the cosmetic outcomes of SPLEP are better.
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Memo
收稿日期:2023-7-8。
基金项目: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);广州地区临床特色技术项目(2023C-TS48);卫生健康技术重点推广项目(XM202403895)
通讯作者:曾纪晓,Email:zengjixiao@163.com