Xingtai People's Hospital, Hebei, Xingtai 054000, China.
J Healthc Eng. 2022 Mar 2;2022:8349851. doi: 10.1155/2022/8349851. eCollection 2022.
To explore the clinical intervention effect of transumbilical single-port laparoscopic-assisted Duhamel operation on children with Hirschsprung's disease (HD) and to analyze the effect of treatment on children with serum C-reactive protein (CRP) and interleukin-6 (IL-6) effects.
Retrospectively select 80 children with HD who underwent surgery in our hospital from May 2017 to May 2020 as the research subjects and they are classified as group A according to the difference of the children's surgical procedures (receiving transumbilical single-port laparoscopic-assisted Duhamel surgery, 40 cases) and group B (receiving conventional laparoscopic surgery, 40 cases), compare the perioperative period (operating time, intraoperative blood loss, surgical posthospitalization, and postoperative gastrointestinal function recovery time), early postoperative complications (perianal dermatitis, urinary retention, enterocolitis, and anastomotic leakage), and late postoperative complications (anastomotic stenosis, dirty stool, recurrence of constipation, and enterocolitis), compare the differences in the levels of CRP and IL-6 between the two groups of children before and after the operation, and conduct a 1-year follow-up of the two groups of children to compare the long-term defecation status.
The surgical time of children in group A, postoperative hospitalization time, and postoperative gastrointestinal function recovery time were significantly shorter than those of group B, and the differences between groups were statistically significant ( < 0.05). A group of patients: the total incidence of postearly complications was 5.00% lower than 22.50% ( < 0.05) in group B ( < 0.05), and the total incidence of previous complications after group A of patients was 10.00% lower than 27.50% of group B ( < 0.05). The two groups of serum CRP and IL-6 in two groups were not statistically significant ( > 0.05), and the serum CRP and IL-6 levels of children in group A after surgery were 3 days. It is obviously lower than those in group B, and the differences between groups have statistical significance ( < 0.05). At 1 month after surgery, the average bowel movement time in group A is significantly lower than those of group B ( < 0.05); during the 1-12 months, the difference between the defecation frequency group of the group A and group B did not have statistically significance ( > 0.05).
Transumbilical single-port laparoscopic assistant Duhamel operation of HD has a good intervention effect, compared to traditional laparoscopic surgery, the operation time, postoperative hospitalization time, and postoperative gastrointestinal function recovery time, and also help to reduce postoperative near-long complications The incidence improves the stress reactions and long-term defecation functions in children.
探讨经脐单孔腹腔镜辅助 Duhamel 手术治疗小儿先天性巨结肠(HD)的临床干预效果,并分析其对患儿血清 C 反应蛋白(CRP)、白细胞介素-6(IL-6)水平的影响。
回顾性选择 2017 年 5 月至 2020 年 5 月在我院行手术治疗的 80 例 HD 患儿作为研究对象,根据患儿手术方式的不同分为 A 组(行经脐单孔腹腔镜辅助 Duhamel 手术,40 例)和 B 组(行常规腹腔镜手术,40 例),比较两组患儿围手术期(手术时间、术中出血量、术后住院时间、术后胃肠功能恢复时间)、早期术后并发症(肛周皮炎、尿潴留、吻合口漏、小肠结肠炎)、晚期术后并发症(吻合口狭窄、污便、便秘复发、小肠结肠炎),比较两组患儿术前、术后 CRP 和 IL-6 水平的差异,并对两组患儿进行 1 年随访,比较两组患儿的远期排便情况。
A 组患儿手术时间、术后住院时间、术后胃肠功能恢复时间均明显短于 B 组,组间差异具有统计学意义(<0.05);A 组患儿:早期并发症总发生率为 5.00%,低于 B 组的 22.50%(<0.05);晚期并发症总发生率为 10.00%,低于 B 组的 27.50%(<0.05)。两组患儿术前 CRP 和 IL-6 水平比较,差异无统计学意义(>0.05);A 组患儿术后 3 d 时 CRP 和 IL-6 水平明显低于 B 组,组间差异具有统计学意义(<0.05)。术后 1 个月时,A 组患儿平均排便时间明显低于 B 组(<0.05);术后 1~12 个月时,两组患儿排便频率组间差异无统计学意义(>0.05)。
经脐单孔腹腔镜辅助 Duhamel 术治疗 HD 具有较好的干预效果,与传统腹腔镜手术相比,具有手术时间短、术后住院时间短、术后胃肠功能恢复时间短等优势,还有助于降低术后近远期并发症发生率,改善患儿应激反应和远期排便功能。