CAJ | 학술논문

目的探讨腹腔镜辅助 Soave 巨结肠根治术的疗效及并发症的防治。方法回顾性分析本院2008—2013年收治的115例先天性巨结肠患儿临床资料，均行腹腔镜辅助 Soave 巨结肠根治术，其中男81例，女34例，年龄1个月至14岁，短段型24例，常见型72例，长段型11例，全结肠型8例。结果115例患儿手术均获成功，手术时间60～120 min，平均（95．70±14．17）min，术中出血量3～8 mL，平均（4．8±1．65）mL，术后近期大便5～12次，3～6个月后大便接近正常，每日2～5次，术后发生小肠结肠炎10例，污粪15例，便秘复发2例，吻合口瘘结肠回缩1例，肛周皮炎15例，肛门狭窄3例。结论腹腔镜辅助 Soave 巨结肠根治术治疗小儿先天性巨结肠创伤小，操作简单，安全有效，但也存在一定的并发症。术前诊断、术中术后规范处理，可减少术后并发症的发生。
목적탐토복강경보조 Soave 거결장근치술적료효급병발증적방치。방법회고성분석본원2008—2013년수치적115례선천성거결장환인림상자료，균행복강경보조 Soave 거결장근치술，기중남81례，녀34례，년령1개월지14세，단단형24례，상견형72례，장단형11례，전결장형8례。결과115례환인수술균획성공，수술시간60～120 min，평균（95．70±14．17）min，술중출혈량3～8 mL，평균（4．8±1．65）mL，술후근기대편5～12차，3～6개월후대편접근정상，매일2～5차，술후발생소장결장염10례，오분15례，편비복발2례，문합구루결장회축1례，항주피염15례，항문협착3례。결론복강경보조 Soave 거결장근치술치료소인선천성거결장창상소，조작간단，안전유효，단야존재일정적병발증。술전진단、술중술후규범처리，가감소술후병발증적발생。
Objetive To study the complications and explore their prevention and treatment in the lapa-roscopic-assisted Soave radical macrosigmoid operation. Methods A retrospective review was made on the clinical data of 115 children (81 males and 34 females)who suffered from congenital megacolon and underwent laparoscopic-assisted Soave radical operation.Their age range from 1 month to 14 years.Among the total 115 cases,24 were of short type,72 common type,11 long type,and 8 total colonic type. Results All the 115 patients received successful operation with the mean operative time(95.70 ±14.17)min(range 60 to 120 min).The mean blood loss was (4.8 ±1.65)mL(range 3 ~8 mL).The frequency of defecation shortly after the operation was 5 ~12 times per day,defecation was almost normal 3 ~6 months after operation (2 ~5 times per day).Postoperative complications included enterocolitis in 10 cases (8.7%),perianal dermatitis in 15 cases (13.0%),excrement in 15 cases (13.0%),recurrent constipation in 2 cases (1.7%),anastomotic fistula in 1 case (0.8%),colon retraction in 1 case (0.8%),and anal stenosis in 3 cases (2.6%). Con-clusion Laparoscopic-assisted Soave radical operation in treatment of congenital megacolon in child is mini-in-vasive,easy,safe,effective and has better cosmetic result.Yet some complications,especially those of the long type and the total colonic type,may occur.Preoperative diagnosis,intraoperative and postoperative stand-ardized processing can reduce the postoperative complications.