Transumbilical enterostomy for Hirschsprung’s disease with a two-stage laparoscopy-assisted pull-through procedure

作     者：Pei-Pei Xu Xiao-Pan Chang Xi Zhang Shui-Qing Chi Guo-Qing Cao Shuai Li De-Hua Yang Xiang-Yang Li Shao-Tao Tang 

作者机构：Department of Pediatric SurgeryUnion HospitalTongji Medical CollegeHuazhong University of Science and Technology 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2019年第25卷第46期

页      面：6781-6789页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：Supported by the Public Welfare Research and Special Fund of the National Health and Family Planning of China No.201402007 

主　　题：Hirschsprung's disease Transumbilical enterostomy Conventional abdominal enterostomy Laparoscopy Pull through Cosmetic result 

摘      要：BACKGROUND A one-stage laparoscopic operation has recently been considered a favorable option for the management of patients with Hirschsprung s disease(HD)due to its superior cosmetic ***-stage transanal endorectal pull-through for the treatment of rectosigmoid HD has been widely used in newborns without ***,enterostomy is required in some HD cases for enterocolitis and dilated *** transumbilical enterostomy(TUE)and twostage laparoscopy-assisted anorectoplasty were effective and achieved a similar cosmetic effect to one-stage laparoscopy on the abdominal wall in patients with anorectal malformation,but the effect in patients with HD is *** To evaluate the safety,efficacy and cosmetic results of TUE in two-stage laparoscopy-assisted pull-through for *** From June 2013 to June 2018,53 patients(40 boys,13 girls;mean age at enterostomy:5.5±2.2 mo)who underwent enterostomy and two-stage laparoscopy-assisted pull-through for HD with stoma closure were reviewed at our *** enterostomy approaches were used:TUE in 24 patients,and conventional abdominal enterostomy(CAE)in 29 *** patients with rectosigmoid HD had severe preoperative enterocolitis or a dilated colon.26 patients had long-segment HD,and 16 patients had total colonic aganglionosis(TCA).The patients with left-sided HD underwent the two-stage laparoscopic Soave procedure,and the patients with right-sided HD and TCA underwent the laparoscopic Duhamel ***,enterostomy operative time,complications and cosmetic results were respectively *** There were no differences between the groups with respect to gender,age at enterostomy,weight and clinical type(P0.05).No conversion to open technique was *** patients experienced episodes of stomal mucosal prolapse in the TUE group and 1 patient in the CAE group(8.33%vs 3.45%,P0.05).No parastomal hernia was observed in either of the two *** infection at the stom