Laparoscopic modified Swenson pull-through procedure for Hirschsprung's disease in children
- VernacularTitle:腹腔镜下改良Swenson法治疗小儿先天性巨结肠症
- Author:
Jiyan LIU
;
Bin JIANG
;
Tao LI
- Publication Type:Journal Article
- Keywords:
Laparoscopy;
Hirschsprung's disease;
P ull-through operation;
Child
- From:
Chinese Journal of Minimally Invasive Surgery
2005;0(09):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To introduce the experience of l ap aroscopic modified Swenson pull-through procedure for the treatment of Hirschspr ung's disease (HD). Methods A modified Swenson procedure was performed in 100 cases of HD, including 21 cases of short-segment phenotype, 72 cases of common phenotype, and 7 cases of long-segment phenotype. The patients w ere aged 8 months ~ 7 years, with a mean age of 1.5 years. A 0? or 30? laparos cope, with an inner diameter of 0.5 cm, was advanced from the umbilicular port, and operating instruments were introduced into the left and right lower quadaran t of the abdomen. The carbon dioxide was insufflated in the abdominal cavity at a pressure of 8~12 mmHg. Biopsies from the colonic seromuscular layer were made for pathological examinations. Laparoscopic dissection of blood vessels of the m esocolon was carried out closely near the colon, until the level 0.5~1 cm above the dentate line. The rectum and sigmoid was mobilized outside through the anus to complete rectal dissection. The proximal colon then was anastomosed to the re ctum by means of full-thickness suture and diagonal heart-shaped closure. Results All the cases were cured, without fatal cases. The operation time was 80~170 min (mean, 110 min), and the intraoperative blood loss was less than 10 ml. There were 5 cases of subcutaneous emphysema and 6 cases of urinary retention. On a follow-up in all the cases for 6~18 months, 5 cases of colitis, 2 cases of soiling, 1 case of anastomotic stricture, and 1 case of delayed anas tomotic leakage were observed. Conclusions Laparoscopic modifi ed Swenson pull-through procedure for Hirschsprung's disease is worthy of being recommended for its minimal invasion and simplicity of performance.
