Jiao Chunlei, Li Dandan, Wang Pei, Zhuansun Didi, He Ying, Feng Jiexiong
Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, China.
Pediatr Surg Int. 2019 Jun;35(6):685-690. doi: 10.1007/s00383-019-04474-5. Epub 2019 Mar 29.
The present research utilizes a mid-term follow-up study to assess the results of anorectal manometry after laparoscope-assisted heart-shaped anastomosis (LHSA) for Hirschsprung's disease (HSCR), and compares it to a more generally applied approach, the laparoscope-assisted Soave procedure (LSP).
Retrospectively, patients from January 2015 to June 2017 who received LHSA or LSP were included in this study. After surgery, anorectal manometry was performed by the outpatient department. Anal sphincter resting pressure, anal canal length, amplitude of anal contraction, and frequency of anal contraction pre- and postoperatively were recorded. Additionally, mid-term complications were also monitored.
Preoperative manometry showed no statistically significant difference between the LHSA and LSP groups. Postoperatively, anal sphincter resting pressure was lower in the LHSA group (60.64 ± 9.33 vs. 68.84 ± 11.80 mmHg, p = 0.001). Furthermore, anal canal length of the LHSA group was shorter than that of the LSP group (1.41 ± 0.18 vs. 1.53 ± 0.25 cm, p = 0.015). Frequency of anal contraction also showed a statistically significant difference between the LHSA and LSP groups (13.53 ± 2.17 vs. 12.50 ± 2.03 per minute, p = 0.032). The complication rates showed no significant difference and were as follows: incidence of enterocolitis was 13.89% in the LHSA group and 20.45% in the LSP group, incidence of constipation was 11.11% after LHSA and 27.27% after LSP, and incidence of soiling was 13.89% after LHSA and 25.00% after LSP.
Manometric results of this study show satisfactory outcomes after LHSA. LHSA is an advanced surgical technique to make intestinal anastomosis easy and ensure a good prognosis.
本研究采用中期随访研究来评估腹腔镜辅助心形吻合术（LHSA）治疗先天性巨结肠（HSCR）后肛门直肠测压的结果，并将其与更普遍应用的方法——腹腔镜辅助Soave手术（LSP）进行比较。
回顾性纳入2015年1月至2017年6月接受LHSA或LSP治疗的患者。术后由门诊进行肛门直肠测压。记录术前和术后的肛门括约肌静息压、肛管长度、肛门收缩幅度和肛门收缩频率。此外，还监测了中期并发症。
术前测压显示LHSA组和LSP组之间无统计学显著差异。术后，LHSA组的肛门括约肌静息压较低（60.64±9.33 vs. 68.84±11.80 mmHg，p = 0.001）。此外，LHSA组的肛管长度短于LSP组（1.41±0.18 vs. 1.53±0.25 cm，p = 0.015）。肛门收缩频率在LHSA组和LSP组之间也显示出统计学显著差异（每分钟13.53±2.17次 vs. 12.50±2.03次，p = 0.032）。并发症发生率无显著差异，如下：LHSA组的小肠结肠炎发生率为13.89%，LSP组为20.45%；LHSA术后便秘发生率为11.11%，LSP术后为27.27%；LHSA术后污粪发生率为13.89%，LSP术后为25.00%。
本研究的测压结果显示LHSA术后效果良好。LHSA是一种先进的手术技术，可使肠道吻合更容易并确保良好的预后。
