Laparoscopic Duhamel procedure - Management of 30 cases
Laparoscopic Duhamel procedure - Management of 30 cases
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DOI：
10.1007/s004649901149
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发表时间：
1999-10-01
期刊：
影响因子：
--
通讯作者：
Aigrain, Y
中科院分区：
文献类型：
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作者：
de Lagausie, P;Berrebi, D;Aigrain, Y
背景：1995年2月至1998年6月期间，我科共进行了30例腹腔镜Duhamel拉穿手术。方法：我们的主要目的是证明腹腔镜腹部Duhamel手术治疗先天性巨结肠不同部位的可行性。我们使用了 1 个摄像头端口和 3 个工作端口。腹腔镜下移动乙状结肠和后直肠。制作标准的后结肠肛门吻合术，并使用吻合器进行前吻合术。然后在腹腔镜视野下用内吻合器闭合直肠顶部。结果：30 例患者接受了腹腔镜手术。由于技术困难，三个腹腔镜手术被转换。手术时间为100-330分钟。平均术后 2.5 天开始经口喂养。术后平均住院时间为 9 天。术后早期并发症包括 1 例吻合口瘘、1 例直肠后脓肿、2 例尿路感染和 1 例内脏切除（转换后）。未发现小肠结肠炎或小肠结肠炎样症状。现在所有患者均能每日自主排便。结论：腹腔镜杜哈梅尔手术可以安全进行，效果良好。
Background: Between February 1995 and June 1998, 30 laparoscopic Duhamel pull-through procedures were performed in our department.Methods: Our main aim was to prove the feasibility of the laparoscopic abdominal Duhamel procedure for different localizations of Hirschsprung disease. We used one camera port and three working ports. The sigmoid colon and posterior rectum were mobilized laparoscopically. A standard posterior colo-anal anastomosis was fashioned and a stapler was used for the anterior anastomosis. The top of the rectum was then closed by endo stapler under laparoscopic vision.Results: Thirty patients underwent laparoscopic surgery for this procedure. Three laparoscopic procedures were converted, because of technical difficulties. The operative time was 100-330 mn. Oral feeding was started at a mean postoperative time of 2.5 days. Mean postoperative hospitalization was 9 days. Early postoperative complications included 1 anastomotic leak, 1 retrorectal abscess, 2 urinary infections, and 1 evisceration (after conversion). No enterocolitis or enterocolitis-like symptoms were noted. All patients now have daily spontaneous bowel movements.Conclusion: The laparoscopic Duhamel procedure can be performed safely, giving good results.