摘要
目的：通过 Meta 分析腹腔镜辅助与开腹手术治疗先天性巨结肠的疗效与安全性，评价腹腔镜辅助一期手术根治先天性巨结肠的优势。方法检索1998年1月至2013年8月 Pubmed、西文生物医学期刊文献数据库、CCTR、CNKI、中国生物医学文献数据库发表的相关腹腔镜辅助与传统开腹手术治疗先天性巨结肠疗效比较的文献，比较手术时间、术中出血量、术后住院时间、胃肠功能恢复时间、术后早期并发症的发生率（切口感染、粘连性肠梗阻、尿潴留、术后出血）以及远期并发症的发生率（小肠结肠炎、大便失禁、便秘、污粪）。用 Review Manger 5．2软件进行 Meta 分析。结果共9篇文献入选，9篇文献记录先天性巨结肠手术患儿456例，其中腹腔镜手术239例，开腹手术195例。Meta 分析结果显示：腹腔镜手术较开腹手术出血少，住院时间短，差异有统计学意义（P 值均≤0．05），手术时间和术后胃肠功能恢复时间比较，差异无统计学意义（P 值均≥0．05），术后早期并发症的发生率分别为11．61％、21．53％，差异有统计学意义（P 值≤0．05），术后远期并发症率分别为32．90％、42．56％，差异无统计学意义（P 值≥0．05）。结论腹腔镜辅助一期手术根治先天性巨结肠创伤小，恢复快，能有效减少术后早期并发症的发生。
Objective To assess the safety and efficacy of laparoscopic-assisted one-stage pull-through operation for Hirschsprung′s Disease（HD）. Methods The original articles related to laparoscopic-assisted one-stage pull-through compared with open operations for HD published from January 1998 to August 2013 were Colleted in electronic databases（Pubmed,Foreign Medical Journal Service,Cochrane Controlled Trials Register, China National Knowledge Infrastructure,China Biology Medicine disc）.9 articles were included,which com-pared the operation time,blood loss,length of postoperative hospital stays,bowel movements recovery time,rate of early-postoperative complications（wound infection,adhesive intestinal obstruction,urinary retention,postoper-ative hemorrhage）,rate of late-postoperative complications（enterocolitis,fecal incontinence,constipation,soi-ling）.Review Manger 5.2 software was used for Meta-analysis.Results A total of 456 patients with HD were enrolled.including 239 patients in laparoscopic-assisted one-stage pull-through operation and 195 patients in open operation.The intraoperative blood loss and the length of hospital stays were significantly less in laparo-scopic operation than that in open operation（P≤0.05）.But there were no significant difference in operation time and first bowel movement time（P≥0.05）.The early -postoperative complication rate was significantly lower in laparoscopic group than that in open group（11.61% vs 21.53%,P≤0.05）.There were no significant difference in late-postoperative complication rate（32.90% vs 42.56%,P≥0.05）between two groups. Con-clusions Compared with open operations for HD,laparoscopic -assisted one -stage pull-through for HD is safe,which has lower operative damage and can recovery soon,it reduces the incidence of early-postoperative complication.
出处
《临床小儿外科杂志》
CAS
2015年第2期96-101,共6页
Journal of Clinical Pediatric Surgery
基金
贵州省省长基金临床应用专项基金（黔省专合字（2012）98号）,项目名称：腹腔镜辅助经肛门改良Soave一期根治先天性巨结肠的临床研究
