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目的评价腹腔镜辅助次全结肠切除术在治疗先天性巨结肠症及其类缘病中的应用效果。方法回顾分析2002～2006年13例腹腔镜辅助次全结肠切除并升结肠翻转手术(Deloyers术式)治疗先天性巨结肠症及其类缘病的临床资料。年龄4个月～7岁,长段型6例,常见型4例,类缘病3例。分别在脐缘、左右中腹穿置3个5.5 mm Trocar,变换腹腔镜和主操作孔位置离断结肠系膜、游离回肓部.肛门手术为改良Swenson方法。结果全部患儿腹腔镜辅助下顺利完成手术,平均手术时间(114±35)min,术后住院(6.5±1.3)d,无腹腔镜操作相关并发症,随访6个月～4年,1个月内排便由5～20次/d,6个月后逐渐减少至3～5次/d,无大便失禁及便秘复发。结论腹腔镜辅助次全结肠切除术是一种安全有效的治疗方法.明显优于传统开腹手术,更能体现微创的优越性,值得推广应用。
Objective To evaluate the effect of laparoscopic assisted subtotal colectomy in the treatment of Hirschsprung’s disease and its related diseases. Methods The clinical data of 13 patients with Hirschsprung’s disease and its genital diseases treated by laparoscopic assisted subtotal colon resection and ascending colonic inversion surgery (Deloyers procedure) from 2002 to 2006 were retrospectively analyzed. Aged 4 months to 7 years old, long segment in 6 cases, common in 4 cases, 3 cases of genital disease. At the umbilical edge, there were three 5.5 mm Trocars punctured in the middle and abdomen, respectively, and the laparoscopic and main operation holes were transplanted to separate the mesocolon from the mesangial septum. The anus operation was modified Swenson’s method. Results All the patients underwent laparoscopic surgery successfully. The mean operation time was (114 ± 35) min, postoperative hospitalization was (6.5 ± 1.3) days, laparoscopic-related complications were not observed, followed up for 6 months to 4 years and 1 Defecation by the month 5 to 20 times / d, 6 months after gradually reduced to 3 to 5 times / d, no incontinence and constipation recurrence. Conclusions Laparoscopic assisted subtotal colon resection is a safe and effective treatment, which is obviously superior to traditional laparotomy and can better reflect the superiority of minimally invasive surgery, so it is worth popularizing and applying.