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目的 :介绍小儿腹腔镜改良 Soave根治术治疗先天性巨结肠症 2 2例 ,对手术并发症的预防和治疗进行探讨。方法 :腹腔镜下分离要切除的病变结肠系膜 ,结肠从直肠肌鞘内拖出与肛门吻合。对腹内大出血和术后肛门吻合口感染 ,部分结肠回缩 ,以及并发小肠结肠炎进行分析和治疗。结果 :本组并发症 5例 ,占 2 2 .7% ,经治疗后均痊愈出院。术后随访 2 0例均食欲正常、无腹胀 ,每天自行排便 2～ 5次 ,肛门吻合口无狭窄、无粪污 ,体重增加。结论 :小儿腹腔镜巨结肠根治术是一种新型手术方法 ,与传统的先天性巨结肠开腹根治术比较 ,术中术后并发症少。对术中腹内大出血以及术后肛门吻合口感染结肠回缩等严重并发症 ,只要处理得当完全可以避免。因此小儿腹腔镜为新生儿、婴幼儿先天性巨结肠症的治疗提供了一种新的安全有效的方法。
Objective: To introduce the modified Laparoscopic radiculotomy for Hirschsprung disease in 22 cases, to discuss the prevention and treatment of complications. Methods: Laparoscopic resection of the lesion to be removed from the mesocolon, the colon from the rectum muscular sheath and anal anastomosis. Intrahepatic hemorrhage and anal anastomotic infection, partial colon retraction, and enterocolitis were analyzed and treated. Results: The group of complications in 5 cases, accounting for 22.7%, were cured after treatment were discharged. Twenty patients were followed up for normal appetite, no abdominal distension, bowel movements 2 to 5 times per day, anal anastomotic without stenosis, no manure, weight gain. Conclusions: Pediatric laparoscopic radical hysterectomy is a new surgical method. Compared with the traditional radical hysterectomy, there are few postoperative complications. Severe intraoperative abdominal bleeding and anal anastomotic infections such as colon retraction and other serious complications, as long as properly handled can be avoided. Therefore, pediatric laparoscopy for neonatal, infant Hirschsprung’s disease treatment provides a new safe and effective method.