临床外科杂志 ›› 2023, Vol. 31 ›› Issue (7): 690-693.doi: 10.3969/j.issn.1005-6483.2023.07.024

• 论著 • 上一篇    下一篇

腹腔镜或机器人辅助Duhamel拖出术后留置肛管时间对巨结肠患儿术后恢复的影响

  

  1. 530005 南宁, 广西壮族自治区妇幼保健院小儿普外科(孔德建);华中科技大学同济医学院附属协和医院小儿外科(李帅、曹国庆、张茜、罗智彬 、汤绍涛
  • 收稿日期:2022-05-29 接受日期:2022-05-29 出版日期:2023-07-20 发布日期:2023-07-20
  • 通讯作者: 汤绍涛,Email:tshaotao83@126.com

The effect of laparoscopic or robotic-assisted Duhamel pull-through procedure postoperative rectal tube indwelling time on recovery of children

  1. Department of Pediatric General Surgery,Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region,Nanning 530005, China
  • Received:2022-05-29 Accepted:2022-05-29 Online:2023-07-20 Published:2023-07-20

摘要: 目的   探讨长段型先天性巨结肠及肠神经节细胞发育不良患儿行腹腔镜或机器人辅助Duhamel拖出术后留置肛管不同时间对术后恢复的影响。 方法   2019年1月~2021年12月29例长段型巨结肠,56例肠神经节细胞发育不良保守治疗无效行微创肛门外横断直肠Duhamel拖出术,术后常规留置肛管,根据实际留置肛管时间的不同分为三组:A组,置管时间≤3天,8例;B组,置管时间4~6天,15例;C组,置管时间≥7天,62例。比较术中及术后疗效。 结果   三组病例在术后1年内小肠结肠炎发生次数、术后腹胀、肛周不适的发生率比较差异有统计学意义(P<0.05)。 结论   先天性巨结肠长段型及肠神经节细胞发育不良患儿行微创肛门外横断直肠的Duhamel拖出术后留置肛管时间长,有利于减少术后腹胀、肛周不适及小肠结肠炎的发生率。


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

[1] 张慧敏 解凤妮 吴肖 李云龙. 重症胰腺炎腹腔开放冲洗引流术后早期卧床踏步机运动对恢复的影响[J]. 临床外科杂志, 2022, 30(10): 973-976.
[2] 梁鹏, 李万富. 先天性巨结肠相关性小肠结肠炎发病机制研究及治疗进展[J]. 临床外科杂志, 2021, 29(6): 587-589.
[3] 施诚仁. 先天性巨结肠外科处理后的远期转归[J]. 临床外科杂志, 2012, 20(8): 529-530.
[4] 朱天琦 魏明发 冯杰雄 孙晓毅 翁一珍 张文 易斌 余东海 吴晓娟 张雪琴. 腹腔镜和开腹结肠切除手术治疗先天性巨结肠临床观察[J]. 临床外科杂志, 2012, 20(2): 102-102.
[5] 王俊. 先天性巨结肠再次手术的策略[J]. 临床外科杂志, 2011, 19(8): 519-519.
[6] 吴火友 陈少全 王烈 翟亚楠. 小切口联合粘贴式负压冲吸器在直肠肛管周围脓肿治疗中的应用[J]. 临床外科杂志, 2011, 19(11): 754-754.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!