腹腔镜与超声刀配合在巨结肠根治术中的应用

目的 探讨腹腔镜与超声手术刀配合在先天性巨结肠手术中的应用前景。方法 128例先天性巨结肠患儿，常见型107例，长段型9例，短段型12例，在腹腔镜下用超声手术刀游离切断结肠系膜，肛门入路分离直肠粘膜，行改良Soave巨结肠根治术。结果 118例完全在腹腔镜下完成系膜游离、7例在腹部加做4～5cm切口完成手术。术后1例腹膜后血肿、5例肛门部肠管脱垂，无其他严重并发症，短期随访手术效果良好。结论 超声手术刀与腹腔镜配合，是目前各种先天性巨结肠微创手术中适应证最广的术式。

Study of Application of Peritoneoscope and Ultrasonic Surgical Knife in Radical Operation of Giant Colon

Objective To research the respects of peritoneoscope and ultrasonic surgical knife used for radical operation of congenital giant colon. Method 128 children with congenital gaint colon, included general type in 107 cases, a long segment type in 9 cases and a short segment type in 12 cases, all patients mesocolons were freed and were excised by ultrasonic knife with peritoneoscope guide,then rectal mucosas were isolated using anus approach.Final,the modified Soave radical operation of gaint colon were performed.Results The free operation of the mesocolon was performed in 118 cases by peritoneoscope only,other 7 cases,in addition to the operation,on abdomen plus celiotomy,which had a 4cm~5cm incision.One cases of them occurred retroperitoneal hematom,5 cases had intestine prolapse in the perianal part,after the above operation No severe complication was seen.A short term followed up showed that the operation acquired a good efficacy.Conclusions In combination of peritoneoscope and ultrasonic surgical knife could overcome the difficulty in deal with mesentery blood vessels.It is best suitable extensively applied in the microtraumatic operation for various congenital megacolon.