Xia Renpeng, Ma Tidong, Zhao Fan, Xiao Yong, Feng Yong, Li Ming, Zou Chanjuan, Xu Guang, Zhou Chonggao
Department of Fetal & Neonatal Surgery, The Affiliated Children's Hospital of Xiangya School of Medicine, Central South University (Hunan Children's Hospital), Changsha, 410007, China.
Sci Rep. 2024 Dec 30;14(1):31924. doi: 10.1038/s41598-024-83422-3.
To evaluate the efficacy of laparoscopic-assisted Soave procedure of Hirschsprung's Disease (HSCR) in neonates and infants within 3 months of age. Patients with HSCR who were admitted to the Department of Fetal and Neonatal Surgery of Hunan Children's Hospital from June 2012 to July 2020 and underwent laparoscopic-assisted Soave procedure were selected. The clinical manifestations, surgical procedures, postoperative fecal contamination, constipation, enterocolitis, and defecation function were analyzed. A total of 267 children were included, 230 males and 37 females. Vaginal delivery occurred in 138 cases (51.7%) and cesarean delivery in 129 cases (48.3%). There were 217 cases (81.3%) of delayed excretion of meconium, preoperative HAEC (Hirschsprung's Disease Associated enterocolitis) 116 cases (43.4%), postoperative HAEC 54 cases (20.2%), 1 cases of postoperative death, 266 cases (99.6%) were cured. There were 37 cases (13.9%) of long-segment type, 226 cases (84.6%) of common type, and 4 cases (1.5%) of short-segment type. Of the 267 cases, 214 cases were followed up (80.1%), 60 cases with fecal contamination, the incidence rate was 28.0%, and 5 cases were tertiary fecal contamination. The overall incidence of constipation was 3.7% (8 cases), and 2 cases were third-degree constipation. Evaluation of defecation function: The excellent rate was 94.4%. Laparoscopic-assisted Soave procedure in neonates and infants within 3 months of age is generally safe and feasible, most infants have good postoperative defecation function, and the incidence of postoperative fecal contamination, constipation, and enterocolitis is relatively low.
评估腹腔镜辅助Soave手术治疗3个月龄内新生儿和婴儿先天性巨结肠(HSCR)的疗效。选取2012年6月至2020年7月在湖南省儿童医院胎儿与新生儿外科住院并接受腹腔镜辅助Soave手术的HSCR患儿。分析其临床表现、手术过程、术后粪便污染、便秘、小肠结肠炎及排便功能。共纳入267例患儿,男230例,女37例。顺产138例(51.7%),剖宫产129例(48.3%)。胎粪排出延迟217例(81.3%),术前合并先天性巨结肠相关小肠结肠炎(HAEC)116例(43.4%),术后合并HAEC 54例(20.2%),术后死亡1例,治愈266例(99.6%)。长段型37例(13.9%),常见型226例(84.6%),短段型4例(1.5%)。267例中,随访214例(80.1%),粪便污染60例,发生率为28.0%,其中三度粪便污染5例。便秘总发生率为3.7%(8例),三度便秘2例。排便功能评估:优良率为94.4%。3个月龄内新生儿和婴儿行腹腔镜辅助Soave手术总体安全可行,多数患儿术后排便功能良好,术后粪便污染、便秘及小肠结肠炎发生率较低。