关键词: 腹腔镜改良Soave短肌鞘术式；先天性巨结肠；传统腹腔镜Soave巨结肠根治术；排便功能；并发症

Abstract: Objective To observe the efficacy,safety and defecation function of laparoscopic modified Soave short muscle sheath in the treatment of children with Hirschcolon (HD).Methods A total of 91 children with HD admitted to our hospital from January 2018 to May 2023 were selected for the study,and were divided into observation group (modified laparoscopic Soave short muscle sheath operation,41 cases) and control group (traditional laparoscopic Soave Hirschacolon radical resection,50 cases) according to random number table method.Operation time,postoperative blood loss,postoperative defecation time,postoperative hospital stay,length of resection intestine and preoperative enema time were compared between the two groups.White blood cell count (WBC) and C-reactive protein (CRP) levels before and after operation were compared between the two groups,and pain scores were compared between the two groups 12h,24h,36h and 48h after operation.Postoperative defecation function and postoperative complications were compared between the two groups.Results The operation time[（134.07±22.08）min],postoperative blood loss[（5.17±0.87）ml],postoperative defecation time[（2.10±0.32）d],postoperative hospital stay[（7.59±1.25）d],length of intestinal tube resection[（15.24±2.25）cm] and preoperative enema time[（13.61±2.14）min] in observation group were all lower than those in control group[(159.78±25.44)min,（7.61±1.41）ml,（2.46±0.53）d,（10.59±1.84）d,（16.67±2.54）cm and（16.44±2.57）min](P<0.05).After operation,the serum WBC and CRP levels of the two groups were significantly increased,but the serum WBC and CRP levels of the observation group were lower than those of the control group (P<0.05).The pain scores of the observation group（3.42±0.69,3.17±0.64,2.52±0.58,2.06±0.53） at 12h,24h,36h and 48h were lower than those of the control group（4.47±0.76,3.78±0.72,3.31±0.66,2.83±0.64）(P<0.05).There was no significant difference in defecation function between the two groups (P>0.05).The total incidence of postoperative complications was 17.07% in the observation group,which was lower than 34.00% in the control group (P<0.05).Conclusion The effect of laparoscopic modified Soave short muscle sheath in HD children is better,which can effectively improve various clinical indicators and defecation function,relieve postoperative pain,reduce the degree of infection,reduce postoperative complications,and have higher safety.

Key words: laparoscopic modified Soave short muscle sheath operation；congenital megacolon；traditional laparoscopic Soave megacolon radical surgery；defecation function；complication