SUN Chi,YU Zeng wen,LI Suo lin,et al.Transumbilical single port laparoscopy hybrid transanal endorectal pullthrough for Hirschsprung’s disease.[J].Journal of Clinical Pediatric Surgery,2011,10(01):0.
腹腔镜经脐及肛门自然腔道巨结肠根治术临床分析
- Title:
- Transumbilical single port laparoscopy hybrid transanal endorectal pullthrough for Hirschsprung’s disease.
- 关键词:
- 腹腔镜; Hirschsprung病; 肛门; 直肠
- Keywords:
- Laparoscopes; Hirschsprung disease; Rectum
- 摘要:
- 目的探讨经脐单孔腹腔镜监视下联合经肛门直肠内拖出结肠切除术治疗先天性巨结肠及其类缘性疾病的可行性和临床疗效。方法2010年3～11月，对15例常见型和长段型先天性巨结肠及其类缘病患儿实施经脐单孔腹腔镜监视下联合经肛门直肠肌鞘入路游离左半结肠或全部结肠，然后拖出在体外完成直肠乙状结肠或次全结肠切除术。结果全部患儿均顺利完成手术，11例行直肠乙状结肠切除术，4例行次全结肠切除术；手术时间105～225min，平均（138±18）min；切除肠段35～80cm，估计术中出血5～20mL，无围手术期并发症。13例获随访，随访期间患儿无吻合口狭窄或便秘复发，肛管直肠测压反应良好；2例失访。结论经脐单孔腹腔镜辅助巨结肠根治术治疗先天性巨结肠安全、有效、可行，创伤更小，术后无可见的手术瘢痕，达到了经自然腔道内镜手术（NOTES）的美观效果。
- Abstract:
- Objective To explore the feasibility and outcomes of single port laparoscopy with transanal endorectal pullthrough for Hirschsprung’s disease and allied disorder.MethodsFrom March to November 2010, 15 infants and children with Hirschsprung’s diseaseallied disorder underment a transumbilical single port laparoscopic Soave procedure.Under the laparoscopie vision,the left hemicolon or whole colon were mobilized via rectal muscular sleeve access, then transanal endorectal pullthrough to complete a rectosigmoidectomy or subtotal colectomy.ResultsAll operations were completed successfully. Rectosigmoidectomy were performed in 11 cases, subtotal colectomy in 4 cases. The average operative time was 138±18min (range, 105 to 225min). The lengrh of the resected segment was 35~80cm, and the estimated blood loss was 5~20mL. There were no unanticipated intraoperative or postoperative complications. At the time of followup, 13 children had no stoma stenosis or constipation recurrence, and the result of anorectal manometry was good.ConclusionsTransumbilical single port laparoscopic Soave operation is a safe, effective and feasible procedure, with more minimal invasion, invisible scars in the abdomen, and nearly the cosmetic result of NOTES.
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CAO Guo qing,TANG Shao tao,YANG Ying et al..The clinical analysis of laparoscopic transanal puuthrough operation for rectosigmoild Hirschsprung disease (122 cases report).[J].Journal of Clinical Pediatric Surgery,2011,10(01):0.
备注/Memo
作者单位：河北医科大学第二医院小儿外科（石家庄市，050000），通讯作者：李索林，Email:lisuolin@263.net，本研究为国家“十一五”科技支撑计划资助项目（2006BAI05A06）