CAJ | 학술논문

目的探讨经脐腹腔镜结肠肛门拖出术用于儿童神经节细胞减少症的治疗效果.方法回顾性分析2009年6月至2010年6月间在华中科技大学同济医学院附属同济医院接受经脐腹腔镜肛门拖出手术的12例神经节细胞减少症患儿的临床资料.结果手术使用特制的弯曲手柄型加长器械进行操作,无一例患儿中转开腹或改行传统腹腔镜手术.术中无腹部血管、肠管、输尿管或输精管损伤,平均手术时间140 min,平均术中失血量45 ml,平均切除病变肠管长度40 cm.术后无吻合口瘘、吻合口狭窄、便秘、污粪、排粪失禁等并发症出现,平均术后住院时间9d.术后1个月复诊时均未见明显手术瘢痕.术后经10～22(中位时间16)个月的随访,无一例复发.结论经脐腹腔镜肛门拖出术治疗神经节细胞减少症简单、安全并有效.
목적 탐토경제복강경결장항문타출술용우인동신경절세포감소증적치료효과.방법 회고성분석2009년6월지2010년6월간재화중과기대학동제의학원부속동제의원접수경제복강경항문타출수술적12례신경절세포감소증환인적림상자료.결과 수술사용특제적만곡수병형가장기계진행조작,무일례환인중전개복혹개행전통복강경수술.술중무복부혈관、장관、수뇨관혹수정관손상,평균수술시간140 min,평균술중실혈량45 ml,평균절제병변장관장도40 cm.술후무문합구루、문합구협착、편비、오분、배분실금등병발증출현,평균술후주원시간9d.술후1개월복진시균미견명현수술반흔.술후경10～22(중위시간16)개월적수방,무일례복발.결론 경제복강경항문타출술치료신경절세포감소증간단、안전병유효.
Objective To investigate the surgical outcomes after on transumbilical laparoscopic pull-through procedure for pediatric hypoganglionosis (HYP).Methods Twelve children with HYP had received transumbilical laparoscopic pull-through procedure from June 2009 to June 2010.Specially designed curved and elongated laparoscopic instruments were used during the procedures.All the patients were followed up over 10 months.Data were collected and analyzed.The diagnosis of hypoganglionsis was pathologically confirmed.Results No conversions to laparotomY or traditional laparoscopic surgery were required and there were no damages to the abdominal blood vessels,intestine,ductus deferens,or ureters.The average duration of operation was 140 min.The mean intraoperative blood loss was 45 ml.The mean length of specimen was 40 cm.Postoperatively there were no complications suchas anastomotic leak,anastomotic stricture,constipation,secpage,or fecal in continence.The average hospital stay after surgery was 9 days.During 10 to 22 months of follow-up (median 16 months),no postoperative recurrence was noticed.No obvious scar was seen 1 months after surgery.Conclusion It is safe and effective for children with hypoganglionosis to undergo transumbilical laparoscopic pull-through procedure.