Department of Pediatric Surgery, Dongguan Children's Hospital, Dongguan, China.
Medicine (Baltimore). 2023 Dec 29;102(52):e36744. doi: 10.1097/MD.0000000000036744.
This study aimed to compare and analyze the postoperative complications and anal function after 3-stage laparoscopic-assisted anorectoplasty (LAARP) and conventional posterior sagittal anorectoplasty (PSARP) in the treatment of moderate to severe anal atresia in children. A total of 27 children with moderate to severe anal atresia who underwent conventional PSARP at the Dongguan Children Hospital between 2007 and 2011 were included in the control group, and 34 children with moderate to severe anal atresia who underwent 3-stage LAARP between 2012 and 2016 were included in the observation group. The incidence of postoperative complications and Kelly score of anal function in the 2 groups were statistically analyzed and the efficacy of the 2 procedures compared. The incidence of postoperative complications such as wound infection, anal stenosis, anastomotic leakage, fecal incontinence, and constipation in the LAARP group was lower as compared with the PSARP group, and there was a statistically significant difference (P < .05). There was no significant difference in the incidence of postoperative complications such as rectal prolapse, diarrhea, and recurrent fistula between the LAARP group and the PSARP group (P > .05). The Kelly score of anal function was higher in the LAARP group than in the PSARP group, and the difference was statistically significant (P < .05). Compared to conventional PSARP, laparoscopic surgery for moderate to severe anal atresia in children has less complications, improved anal function, and a clear therapeutic impact.
本研究旨在比较和分析 3 期腹腔镜辅助肛门直肠成形术(LAARP)与传统后路矢状位肛门直肠成形术(PSARP)治疗儿童中重度肛门闭锁的术后并发症和肛门功能。选取 2007 年至 2011 年在东莞市儿童医院接受传统 PSARP 治疗的 27 例中重度肛门闭锁患儿为对照组,选取 2012 年至 2016 年接受 3 期 LAARP 治疗的 34 例中重度肛门闭锁患儿为观察组。统计分析两组患儿术后并发症发生率及肛门功能 Kelly 评分,并比较两种术式的疗效。LAARP 组术后感染、肛门狭窄、吻合口漏、大便失禁、便秘等并发症的发生率低于 PSARP 组,差异有统计学意义(P<0.05);LAARP 组术后直肠脱垂、腹泻、复发瘘等并发症的发生率与 PSARP 组比较,差异无统计学意义(P>0.05);LAARP 组肛门功能 Kelly 评分高于 PSARP 组,差异有统计学意义(P<0.05)。与传统 PSARP 相比,腹腔镜手术治疗儿童中重度肛门闭锁的并发症较少,肛门功能改善,治疗效果明确。