【摘要】 目的:探讨腹腔镜下改良Soave短肌鞘术治疗常见型先天性巨结肠(HD)的临床效果。方法:回顾分析2019年1月至2023年4月收治的60例常见型HD患儿的临床资料，分别行腹腔镜改良Soave短肌鞘术(n=20,改良组)与传统腹腔镜Soave术(n=40,传统组)。对比分析两组围手术期指标、术后早期排便功能、术后并发症及术后6个月肛门排便控制效果。结果:改良组手术时间、肛门操作时间、术后排气时间短于传统组，术中出血量少于传统组，术后白蛋白水平高于传统组，术后1个月每天排便次数少于传统组，术后恢复正常排便时间短于传统组，术后并发症总发生率低于传统组，术后6个月的肛门功能优良率高于传统组，差异均有统计学意义(P<0.05)。结论:与腹腔镜下传统Soave术相比，腹腔镜下改良Soave短肌鞘术治疗小儿常见型HD可减少术后并发症，改善排便功能。更多还原

【Abstract】 Objective:To explore the clinical efficacy of laparoscopic modified Soave short muscle sheath surgery in the treatment of classic-type Hirschsprung disease in children.Methods:A retrospective analysis was conducted, 60 children with classic-type Hirschsprung disease admitted from Jan.2019 to Apr.2023 were selected.According to different surgical plans, they were divided into modified Soave short muscle sheath surgery(n=20,improved group) and traditional laparoscopic Soave surgery(n=40,traditional group).Perioperative indicators, early postoperative defecation function, postoperative complications, and anal defecation control at 6 months were analyzed and compared between the two groups.Results:The improved group had a shorter operation time, shorter anal operation time, less intraoperative blood loss, shorter time to first flatus, and higher postoperative serum albumin value compared to the traditional group, with statistically significant differences; compared with the traditional group, the improved group had a shorter time to achieve normal defecate movements and fewer daily defecation frequency one month after surgery, and the difference was statistically significant(P<0.05).Compared with the traditional group, the overall incidence of postoperative complications was significantly lower in the improved group, the excellent and good rate of anal function in the improved group at 6 months after surgery was higher than that in the traditional group, with statistically significant differences(P<0.05).Conclusions:Compared with traditional Soave surgery, laparoscopic modified short muscle sheath Soave procedure can reduce postoperative complications and achieve better defecation function in children with classic-type Hirschsprung disease.更多还原