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对拉皮镜辅助二阶段和三阶段直肠整形术的结果进行比较研究

Haoyuan Zhang¹, Jingmin Zhang², Yan Zhou³

¹Department of Pediatric Surgery, Capital Institute of Pediatrics, Beijing, People's Republic of China; Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China; Research Unit of Minimally Invasive Pediatric Surgery on Diagnosis and Treatment(2021RU015), Chinese Academy of Medical Sciences, Beijing, People's Republic of China.

Journal of pediatric surgery

|April 12, 2025

概括

对于直肠形 (ARM) 的两阶段腹腔镜辅助直肠拉透 (LAARP) 没有比三阶段LAARP提供优势. 这种方法增加了直肠脱落率和家庭负担,而没有成本或住院福利.

科学领域:

儿科手术儿科手术
胃肠病学胃肠病学
泌尿器科泌尿器科泌尿器科泌尿器科

背景情况:

使用腹腔镜辅助的直肠拉透 (LAARP) 进行直肠形 (ARM) 的治疗正在讨论中.
对比两阶段与三阶段LAARP的中期结果对于临床决策至关重要.

研究的目的:

评估和比较ARM的两阶段和三阶段LAARP的中期结果.
评估两种手术方法之间的并发症,肠道功能,成本和住院费用.

主要方法:

一项回顾性研究包括了251名在2007年至2019年期间接受LAARP的儿童.
32名儿童进行了两阶段的LAARP,219人进行了三阶段的LAARP.
用1:4的倾向分数匹配 (PSM) 来进行后期对结果的比较.

主要成果:

在PSM后,两阶段组的并发症率显著更高 (P=0.002).
在两阶段组中,直肠缩发生的频率更高 (50.0%对15.7%,P=0.000).
在成本,术后住院,肠功能得分 (BFS) 或修改的克里肯贝克得分方面没有发现显著差异.

结论:

对ARM的两阶段LAARP不会节省成本,减少住院治疗或改善预后.
两阶段的方法与增加的直肠和家庭负担有关.
三阶段的LAARP似乎是管理ARM的更有利的选择.

关键词:

阴道直肠形阴道直肠形结肠直肠切除术 (colostomy) 是一个大肠直肠切除术.腹腔镜辅助直肠整形手术 (Laparoscopic-assisted anorectoplasty) 是一种手术,可以通过眼镜进行.

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