关键词: 先天性巨结肠, 肠神经节细胞发育不良, Duhamel拖出术, 肛管, 术后恢复

Abstract: Objective   To explore the effect of laparoscopic or robotic-assisted Duhamel pull-through procedure postoperative rectal tube indwelling time on recovery of children with long segment Hirschsprung disease (HD) and intestinal neuronal dysplasia (IND-B). Method   The clinical data of 29 cases with long segment HD and 56 cases with IND-B failed to conservative treatment,received minimallly invasive external anal transection rectum Duhamel pull-through procedure from January,2019 to December,2021 were retrospectively analyzed.Postoperative routine indwelling rectal tube.According to actual rectal tube indwelling time,the patients were divided into 3 groups to analyzed：Group A, catheterization time ≤3 days, 8 cases; Group B, catheterization time 4-6 days, 15 cases; Group C, catheterization time ≥7 days, 62 cases，and compared intraoperative and postoperative clinical data. Result   There were statistical differences among three groups in terms of the incidence of enterocolitis occured within 1 year after surgery,postoperative abdominal distension and perianal discomfort (P<0.05). Conclusion   In children with long segment Hirschsprung disease (HD) and intestinal neuronal dysplasia (IND-B),longer rectal tube indwelling time after minimallly invasive external anal transection rectum Duhamel pull-through procedure,which is beneficial to reduce the incidence of postoperative abdominal distention and perianal discomfort and enterocolitis.

Key words: Hirschsprung’s disease, intestinal neuronal dysplasia, Duhamel pull-through procedure, rectal tube, postoperative recovery