Subtotal colectomy with a single-incision laparoscopic surgery technique in children with long-segment Hirschsprung disease and allied disorders

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• 作者：Tianqi Zhu (1)
  Jiexiong Feng (1)
  Wen Zhang (1)
  Mingfa Wei (1)
  Donghai Yu (1)
  Xueqin Zhang (1)
  Kechi Yu (1)
  Houfang Kuang (1)
  
• 关键词：Single ; incision laparoscopic surgery ; Long ; segment Hirschsprung disease ; Hirschsprung allied diseases ; Children
• 刊名：Pediatric Surgery International
• 出版年：2013
• 出版时间：February 2013
• 年：2013
• 卷：29
• 期：2
• 页码：197-201
• 全文大小：344KB
• 参考文献：1. Georgeson KE, Fuenfer MM, Hardin WD (1995) Primary laparoscopic pull-through for Hirschsprung’s disease in infants and children. J Pediatr Surg 30:1017-022 CrossRef
  2. Esposito C (1998) One-trocar appendectomy in pediatric surgery. Surg Endosc 12:177-78 CrossRef
  3. Rispoli G, Armellino MF, Esposito C (2002) One-trocar appendectomy. Surg Endosc 16:833-35 CrossRef
  4. Chow A, Aziz O, Purkayastha S et al (2010) Single incision laparoscopic surgery for acute appendicitis: feasibility in pediatric patients. Diagn Ther Endosc 294958
  5. Rouzrokh M, Khaleghnejad AT, Mohejerzadeh L et al (2010) What is the most common complication after one-stage transanal pull-through in infants with Hirschsprung’s disease? Pediatr Surg Int 26:967-70 CrossRef
  6. Muensterer OJ, Chong A, Hansen EN et al (2010) Single-incision laparoscopic endorectal pull-through (SILEP) for hirschsprung disease. J Gastrointest Surg 14:1950-954 CrossRef
  7. Wang G, Sun XY, Wei MF et al (2005) Heart-shaped anastomosis for Hirschsprung’s disease: operative technique and long-term follow-up. World J Gastroenterol 11:296-98
  8. Piskun G, Rajpal S (1999) Transumbilical laparoscopic cholecystectomy utilizes no incisions outside the umbilicus. J Laparoendosc Adv Surg Tech A 9:361-64 CrossRef
  9. Ergun O, Tiryaki S, Celik A (2011) Single center experience in single-incision laparoscopic surgery in children in Turkey. J Pediatr Surg 46:704-07 CrossRef
  10. Potter DD, Tung J, Faubion WJ et al (2012) Single-incision laparoscopic colon and rectal surgery for pediatric inflammatory bowel disease and polyposis syndromes. J Laparoendosc Adv Surg Tech A 22:203-07 CrossRef
  11. de Armas IA, Garcia I, Pimpalwar A (2011) Laparoscopic single port surgery in children using Triport: our early experience. Pediatr Surg Int 27:985-89 CrossRef
  12. Rangel SJ, de Blaauw I (2010) Advances in pediatric colorectal surgical techniques. Semin Pediatr Surg 19:86-5 CrossRef
  13. Gaujoux S, Bretagnol F, Ferron M et al (2011) Single-incision laparoscopic colonic surgery. Colorectal Dis 13:1066-071 CrossRef
  14. Estevao-Costa J, Fragoso AC, Campos M et al (2006) An approach to minimize postoperative enterocolitis in Hirschsprung’s disease. J Pediatr Surg 41:1704-707 CrossRef
  15. Bentley JF (1964) Some new observations on magacolon in infancy and children with special reference to the management of megasigmoid and megarectum. Dis Colon Rectum 7:462-70 CrossRef
  16. Meier-Ruge W (1971) Casuistic of colon disorder with symptoms of Hirschsprung’s disease. Verh Dtsch Ges Pathol 55:506-10
  17. Emir H, Akman M, Sarimurat N et al (1999) Anorectal manometry during the neonatal period: its specificity in the diagnosis of Hirschsprung’s disease. Eur J Pediatr Surg 9:101-03 CrossRef
  18. Gasparovic I, Kovac D, Persic M et al (2011) Ganglia/nerve fibers ratio correlates with the need for surgery in patients diagnosed with Hirschsprung’s disease allied disorder (HAD). Fetal Pediatr Pathol 30:405-13 CrossRef
  
• 作者单位：Tianqi Zhu (1)
  Jiexiong Feng (1)
  Wen Zhang (1)
  Mingfa Wei (1)
  Donghai Yu (1)
  Xueqin Zhang (1)
  Kechi Yu (1)
  Houfang Kuang (1)
  
  1. Pediatric Surgery Department, Tongji Hospital, 1095# Jiefang Avenue, Wuhan, China
  
• ISSN：1437-9813

文摘

Background Over the last 15?years, the laparoscopic-assisted endorectal pull-through procedure has become the standard treatment for Hirschsprung disease in many centers around the world. Recently, single-incision laparoscopic techniques have drawn more attention. We describe a single-incision laparoscopic surgery (SILS) subtotal colectomy to treat long-segment Hirschsprung disease (LSHD) and Hirschsprung disease allied disorder (HAD) in children. Methods A total of 22 patients who underwent SILS subtotal colectomy, including three patients with a failed first surgery, were included in this retrospective study. For SILS, a 1-cm skin incision was first made below the umbilical margin and a 5-mm trocar was placed into the abdomen after incising the peritoneum. Two 5-mm trocars were then placed on both sides of the umbilicus. Subsequently, based upon preoperative examination and biopsy results, we performed subtotal colectomy. The affected colon was mobilized successively beyond the peritoneum using high-frequency cutting and sealing devices, followed by a pull-through procedure and colon-anal anastomosis. Results The average operative time was 206.39?min. No case needed conversion from SILS to either conventional laparoscopy or open surgery. Of the 22 patients, 15 were diagnosed as LSHD, while 6 cases were diagnosed with intestinal neuronal dysplasia and one was diagnosed with hypoganglionosis. There were no intra-operative complications. One child had incision dehiscence on postoperative day three. During the follow-up over 12?months, all patients were noted to have excellent cosmetic outcomes, and enterocolitis was observed in four children. Conclusions Subtotal colectomy with the SILS technique can be safely performed in LSHD or HAD patients in the pediatric population without major complications.