[1]吴鸿根,黄顺荣,邓洪强,等.腹腔镜辅助下改良Swenson治疗婴幼儿巨结肠[J].中国微创外科杂志,2008,08(3):230-231.
　Wu Honggen,Huang Shunrong,Deng Hongqiang,et al.Clinical Analysis of Laparoscopicassisted Modified Swenson’s Operation for Hirschsprung’s Disease in Infants[J].Chinese Journal of Minimally Invasive Surgery,2008,08(3):230-231.
点击复制

腹腔镜辅助下改良Swenson治疗婴幼儿巨结肠()
分享到：

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
08
期数:
2008年3期
页码:
230-231
栏目:
出版日期:
2008-10-25

文章信息/Info

Title:
Clinical Analysis of Laparoscopicassisted Modified Swenson’s Operation for Hirschsprung’s Disease in Infants
作者:
吴鸿根; 黄顺荣; 邓洪强; 周明; 吴东波; 潘云
广西壮族自治区人民医院外科，南宁530021
Author(s):
Wu Honggen;  Huang Shunrong;  Deng Hongqiang;  et al.
Department of Surgery, People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, China
关键词:
先天性巨结肠; 婴幼儿; 腹腔镜辅助手术
Keywords:
Hirschsprung’s disease; Infant; Laparoscopicassisted surgery
分类号:
R726.1;R656.9
文献标志码:
A
摘要:
目的探讨腹腔镜辅助下改良Swenson治疗婴幼儿巨结肠的可行性和有效性。方法应用腹腔镜辅助下改良Swenson法治疗婴幼儿先天性巨结肠13例，采用三孔或四孔腹腔镜法，设定CO2压力为8~10 mm Hg，取结肠浆肌层组织做病理诊断，Ligasure离断直肠及乙状结肠系膜，远端分离至齿状线上0.5~1.0 cm，将病变狭窄段、移行段扩张肠管经直肠肛门内翻拖出切除，结肠直肠全层前高后低心形斜吻合，3例采用强生直径21 mm吻合器。结果13例均在腹腔镜下顺利完成手术，手术时间85~161 min，平均115 min。出血量<12 ml。均无术中并发症。术后3例小肠结肠炎，1例污粪，1例吻合口漏，经治疗后治愈。13例随访6~42个月，平均26个月，排便正常，无并发症发生。结论腹腔镜辅助下改良Swenson治疗婴幼儿巨结肠可行、有效。
Abstract:
ObjectiveTo evaluate the feasibility and effectiveness of laparoscopicassisted modified Swenson’s operation for Hirschsprung’s disease in infants.MethodsA total of 13 infants with Hirschsprung’s disease including 11 males and 2 females were treated by laparoscopicassisted modified Swenson’s surgery. Three or fourtrocar technique was used under a CO2 pressure of 8-10 mm Hg. The seromuscular layer of the colon was obtained for pathological examination. The mesenteries of the sigmoid colon and rectum were dissected by Ligasure, and the rectum was dissected down to 0.5-1.0 cm above the dentate line. Through the anus, the angusty and transmigration segment of the intestinal canal were evaginated, pulled out, and resected. Wholelayer colonrectum anastomosis was performed,Φ21 mm stapler was used in 3 cases. ResultsAll the operations were completed with laparoscopy in 85-161 min (mean, 115 min). The blood loss was less than 12 ml in all the patients. No intraoperative complications occurred. After the operation, 3 patients developed intestinal inflammation, 1 had anastomotic leakage, and 1 feces stain. All the compilations were cured by conservative treatments. The patients were followed up for 6 to 42 months (mean, 26 months), during which no one had complications.ConclusionLaparoscopicassisted modified Swenson’s operation is feasible and effective for Hirschsprung’s disease in infants.

参考文献/References:

[1]De la Tone ML, Or Tega SJA. Transanal endoretal pullthrough for Hirschsprung’s disease. J Pediatr Surg, 1998, 33(8): 1283-1286.
[2]Georgeson KE. Laparoscopic assisted pull through for Hirschsprung’s disease. Semin Pediatr Surg,2002,11(4):205-210.
[3]刘继炎，姜斌，李涛，等. 腹腔镜下改良法治疗小儿先天性巨结肠症.中国微创外科杂志，2005，5（9）：702－703.
[4]汤绍涛，曹志清，阮庆兰，等. 腹腔镜心形吻合术治疗先天性巨结肠与开腹手术比较. 中国微创外科杂志，2005，5（9）：699－701.
[5]王果，袁继炎，周学锋，等. 直肠肛门管纵切心形吻合术-巨结肠根治术改进.中华小儿外科杂志，1991,12(4)：345-346.
[6]易军，蒋嘉萍，李涛，等. 非开腹式经肛门结肠拖出术治疗小儿先天性巨结肠症.中华小儿外科杂志，2001,22(5)265-266.
[7]肖雅玲，周小渔，李碧香.腹腔镜辅助先天性巨结肠根治术152例经验报告.医学临床研究 2005，22（4）:469-473.
[8]Langer JC, Seifert M, Minkes RK, et al. Onestage soave pullthrough for Hischsprung’s disease: a comparison of the transanal and open approaches. J Pediatr Surg,2001,35(6): 820-822.

更新日期/Last Update: 2013-10-22