Hirschsprung's disease in the laparoscopic transanal pull-through era: implications of age at surgery and technical aspects
Hirschsprung's disease in the laparoscopic transanal pull-through era: implications of age at surgery and technical aspects
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DOI：
10.1007/s00383-017-4187-z
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发表时间：
2018-02-01
影响因子：
1.8
通讯作者：
Yamataka, Atsuyuki
中科院分区：
文献类型：
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作者：
Miyano, Go;Takeda, Masahiro;Yamataka, Atsuyuki
由于一系列因素，腹腔镜经肛门拖出术（LTAPT）年龄对先天性巨结肠（HD）术后肠功能（POBF）的详细影响有些模糊。根据手术年龄对1997年至2015年期间采用我们的改良LTAPT（JLTPAT）治疗的106例连续术后HD病例进行分类; A组：< 3个月（n = 31）; B组：< 3个月（n = 31）。3-11月龄组（n = 44）、1-3岁组（n = 19）、4岁组（n = 12）。通过前瞻性回顾JLTAPT后1、3、5、7和10年的门诊记录，对POBF进行评估，并对5项标准中的每一项进行评分，评分范围为0-2;最佳评分= 10。只有D组的手术时间在统计学上长于A、B和C组。性别比例、失血量、随访时间和POBF评分的差异无统计学意义。随时间推移的平均POBF评分为：A组：6.8、7.6、8.4、8.6和8.4; B组：7.1、7.8、8.3、8.5和9.0; C组：6.9、7.9、8.1、8.3和8.6; D组：7.0、7.4、8.2、8.1和8.5。在HD中，JLTAPT时的年龄与POBF无关。
Detailed implications of age at laparoscopic transanal pull-through (LTAPT) on postoperative bowel function (POBF) in Hirschsprung's disease (HD) are somewhat obscure because of a spectrum of factors.Age at surgery was used to categorize 106 consecutive postoperative HD cases treated by our modified LTAPT (JLTPAT) between 1997 and 2015; group A: < 3 months old (n = 31); group B: 3-11 months old (n = 44); group C: 1-3 years old (n = 19); and group D: ae 4 years old (n = 12). POBF was assessed by reviewing outpatient records 1, 3, 5, 7, and 10 years after JLTAPT prospectively and scoring each of 5 criteria on a scale of 0-2; best score = 10.Only operative time was statistically longer in group D versus groups A, B, and C. Differences in gender ratios, blood loss, duration of follow-up, and POBF scores were not statistically significant. Mean POBF scores over time were: group A: 6.8, 7.6, 8.4, 8.6, and 8.4; group B: 7.1, 7.8, 8.3, 8.5, and 9.0; group C: 6.9, 7.9, 8.1, 8.3, and 8.6; group D: 7.0, 7.4, 8.2, 8.1, and 8.5, respectively.Age at JLTAPT was not correlated with POBF in HD.