临床小儿外科杂志

目的总结腹腔镜辅助Swenson-like巨结肠根治术疗效、并发症及操作经验。方法回顾性分析本院2010年3月至2016年3月采用腹腔镜辅助Swenson-like治疗的105先天性巨结肠症的临床资料,分析其并发症,总结操作经验。结果 105例均在腹腔镜辅助下完成,无中转开腹。手术时间85～205 min,平均(115 ± 18)min。平均切除肠管20～65 cm,平均(35 ± 15)cm。无盆腔脓肿及吻合口狭窄,吻合口瘘2例。所有患儿均能自主排尿和排便,无尿潴留,术后6个月内小肠结肠炎12例(11.4%)。86例男性患儿中80例(93.9%)观察到阴茎自主勃起, 8例(7.6%)出现便秘。结论腹腔镜辅助Swenson-like巨结肠根治术效果良好,术后有较好的控便和排尿功能,可以避免Soave肌鞘和Duhamel闸门所导致的相关并发症。

Objective To sum up the therapeutic benefits,postoperative complications and experience of laparoscopic-assisted Swenson-like approach for Hirschsprung's disease. Methods We retrospectively analyzed our clinical data of 105 Hirschsprung's disease patients who had undergone laparoscopic-assisted Swenson-like approach from March 2010 to March 2016,and assessed postoperative complications and operative techniques. Results All patients were successfully treated by laparoscopic-assisted approach without converting to laparotomy. The operation time of the cases averaged 115±18min(85～205 min)and the average length of resection was 35±15cm(20-65 cm). All patients(100%)had self-defecation and automatic micturition function. In the postoperative 6 months,12 patients had enterocotis(11.4%)and 8 patients had constipation(7.6%).Of 86 male cases,the patients in 80 of them(9.9%)reported the occurrence of penile erection after the operations. Conclusion Laparoscopic-assisted Swenson-like approach is an excellent technique for Hirschsprung's disease,offers excellent long-term outcomes for micturition and defecation function. Also,reduce the related complications caused by Soave Muscle sheath Duhamel pouch.

引言
1 材料与方法
2 结果
3 讨论

图1 A:处理拟切除肠管2级血管,保留边缘血管弓; B:紧贴直肠壁游离至盆底肌以下; C:套叠状拖出直肠乙状结肠,切口设计在直肠后壁齿状线上1cm及直肠前壁齿状线上1.5～2 cm; D:无张力间断全层吻合.<br/>Fig.1 A:Handled the grade 2 vessels of the resected bowel,and retained the edge of the vascular arch; B:Freed closely along with the rectal wall to the bottom of the pelvic floor muscles; C:Pulled out of the rectum and sigmoid colon; incision was designed above dentate line 1cm of posterior rectal wall and above dentate line 1.5～2cm of anterior rectal wall; D:Adopted interrupted full-thickness of anastomosis without tension.

图1 A:处理拟切除肠管2级血管,保留边缘血管弓; B:紧贴直肠壁游离至盆底肌以下; C:套叠状拖出直肠乙状结肠,切口设计在直肠后壁齿状线上1cm及直肠前壁齿状线上1.5～2 cm; D:无张力间断全层吻合.
Fig.1 A:Handled the grade 2 vessels of the resected bowel,and retained the edge of the vascular arch; B:Freed closely along with the rectal wall to the bottom of the pelvic floor muscles; C:Pulled out of the rectum and sigmoid colon; incision was designed above dentate line 1cm of posterior rectal wall and above dentate line 1.5～2cm of anterior rectal wall; D:Adopted interrupted full-thickness of anastomosis without tension.

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备注

引言

1 材料与方法

2 结果

3 讨论

期刊信息

备注

引言

1 材料与方法

2 结 果

3 讨 论

期刊信息

2 结果

3 讨论