Immediate efficacy of transumbilical laparoendoscopic single site surgery assisted modified transanal Soave pull-through for Hirschspung's disease

Hu Hai; Lin Minghui; Li Wei; Lei Dezheng; Chen Jiabo; Sun Quanfeng; Chen Peng; Luo Yige

doi:10.3969/j.issn.1003-5591.2024.04.009

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Immediate efficacy of transumbilical laparoendoscopic single site surgery assisted modified transanal Soave pull-through for Hirschspung's disease

更新时间：2026-11-05

- Immediate efficacy of transumbilical laparoendoscopic single site surgery assisted modified transanal Soave pull-through for Hirschspung's disease
- J Abdominal Surg Vol. 37, Issue 4, Pages: 281-286(2024)
- 作者机构：
  
  1.广西医科大学研究生院，广西南宁 530021
  2.广西医科大学第一附属医院小儿外科，广西南宁 530021
- 作者简介：
  
  Luo Yige， Email： lyg6829@163.com
- 基金信息：
- DOI：10.3969/j.issn.1003-5591.2024.04.009
  CLC： R656.9
- Received：01 October 2023，
  
  Published：22 August 2024
- 稿件说明：
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胡海,林明辉,李伟等.经脐单孔腹腔镜辅助短肌鞘斜形吻合术治疗先天性巨结肠临床研究[J].腹部外科,2024,37(04):281-286.

Hu Hai,Lin Minghui,Li Wei,et al.Immediate efficacy of transumbilical laparoendoscopic single site surgery assisted modified transanal Soave pull-through for Hirschspung's disease[J].J Abdominal Surg,2024,37(04):281-286.
胡海,林明辉,李伟等.经脐单孔腹腔镜辅助短肌鞘斜形吻合术治疗先天性巨结肠临床研究[J].腹部外科,2024,37(04):281-286. DOI： 10.3969/j.issn.1003-5591.2024.04.009.

Hu Hai,Lin Minghui,Li Wei,et al.Immediate efficacy of transumbilical laparoendoscopic single site surgery assisted modified transanal Soave pull-through for Hirschspung's disease[J].J Abdominal Surg,2024,37(04):281-286. DOI： 10.3969/j.issn.1003-5591.2024.04.009.

摘要

目的

探讨经脐单孔腹腔镜辅助短肌鞘斜形吻合术治疗儿童先天性巨结肠（Hirschsprung’s disease， HSCR）的疗效。

方法

回顾性分析广西医科大学第一附属医院2014年1月至2019年12月收治的163例HSCR患儿临床资料，按手术方法的不同分为经脐单孔腹腔镜辅助短肌鞘斜形吻合（TU-LEES）组和传统腹腔镜保留长肌鞘（CLS）组，比较两组的手术时间、术中出血量、术后住院时间、肠管功能恢复时间、术中并发症、术后并发症的情况及术后瘢痕情况。

结果

两组手术均能顺利完成。CLS组中转开放手术3例，TU-LESS组需扩大脐部切口2例。TU-LESS组术后小肠结肠炎、吻合口狭窄的发生率均低于CLS组（均

＜0.05），术后半年TU-LESS组瘢痕美容评估与评级量表小于CLS组（

＜0.05），其余观察指标两组无统计学差异（均

＞0.05）。

结论

经脐单孔腹腔镜辅助短肌鞘斜形吻合术治疗HSCR的方法安全可行，美容效果优于常规腹腔镜手术，吻合口狭窄及小肠结肠炎的发生率低于常规腹腔镜Soave手术。

Abstract

Objective

To evaluate the immediate efficacy of transumbilical laparoendoscopic single-site surgery （TU-LESS） for Hirschsprung's disease （HSCR） with oblique mucosectomy and anastomosis with a short split muscular cuff.

Methods

From January 2014 to December 2019， the relevant clinical data were retrospectively reviewed for 163 HSCR children. According to specific surgical approaches， they were divided into two groups of TU-LESS with oblique mucosectomy and anastomosis with a short split muscular cuff （TU-LESS group） and conventional laparoscopy preserving traditional muscle cuff （CLS group）. Operative duration， volume of intraoperative hemorrhage， postoperative hospitalization stay， recovery time of digestive function， perioperative complications and postoperative SCAR were compared between two groups.

Results

All operations were successfully completed. Three patients in CLS group were converted into open surgery while umbilical incision of 2 cases was expanded in TU-LESS group. The incidence rates of postoperative enterocolitis， anastomotic stenosis and the scores of SCAR （Scar Cosmesis Assessment and Rating） scale were lower in TU-LESS group than those in CLS group （

0.05）. No inter-group differences existed in other observation parameters （

0.05）.

Conclusion

TU-LESS with oblique mucosectomy and anastomosis with a short split muscular cuff is both safe and efficacious for HSCR. And cosmetic effect is better than that of conventional laparoscopy and there is a lower incidence of anastomotic stenosis and enterocolitis.

关键词

Keywords

references

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