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目的比较腹腔镜辅助下Soave法与常规开腹手术治疗长段型先天性巨结肠(Hirschsprung’s disease,HD)的临床疗效。方法 2011年4月至2015年4月收治长段型巨结肠患儿40例,随机分为腹腔镜结肠切除组20例,开腹结肠切除术组20例,比较两组患者的手术时间、术中出血量、术后住院时间及术后并发症(粘连性肠梗阻、小肠结肠炎)。结果腹腔镜组手术时间短,差异有统计学意义((P<0.05);腹腔镜组的术中出血量比开腹组少,差异有统计学意义(P<0.05);腹腔镜组术后住院时间明显短于开腹手术组,差异有统计学意义(P<0.05);腹腔镜组术后肠粘连发生率低于开腹组,差异有统计学意义(P<0.05);术后小肠结肠炎发生率差异无统计学(P>0.05)。结论腹腔镜辅助下Soave法是治疗HD安全、有效的手术方法,术后恢复快,并发症少。
Objective To compare the clinical efficacy of laparoscopic-assisted Soave and conventional laparotomy in the treatment of long-segment Hirschsprung’s disease (HD). Methods From April 2011 to April 2015, 40 children with long-segment megacolon were randomly divided into laparoscopic colon resection group (n = 20) and open abdominal colon resection group (n = 20). The operative time and technique of the two groups were compared In the amount of bleeding, postoperative hospital stay and postoperative complications (adhesive intestinal obstruction, enterocolitis). Results The operation time of laparoscopic group was shorter and the difference was statistically significant (P <0.05). The amount of intraoperative blood loss in laparoscopic group was less than that in open group, the difference was statistically significant (P <0.05) The length of hospital stay was significantly shorter than that of the laparotomy group (P <0.05). The incidence of intestinal adhesion in the laparoscopic group was lower than that of the laparotomy group, the difference was statistically significant (P <0.05) There was no significant difference in the incidence of colitis between the two groups (P> 0.05) .Conclusion Laparoscopy-assisted Soave method is a safe and effective surgical method for the treatment of HD with rapid recovery and fewer complications.