腹腔镜Soave手术与开腹Soave手术治疗儿童先天性巨结肠的Meta分析

A Meta Analysis of Laparoscopic Soave Surgery and Open Soave Surgery for the Treatment of Hirschsprung Disease in Children

摘要: 目的：对比腹腔镜及开腹Soave手术在治疗儿童巨结肠病当中相关指标，从而为选择手术方式提供参考依据。方法：检索Pubmed、中国知网、万方等诸多数据库发表的相关腹腔镜Soave手术与开腹Soave手术疗效比较的文献，从中提取相关指标及并发症的数据并meta分析。结果：共12篇文献入选，记录此病腹腔镜Soave手术966例，开腹Soave手术744例。Meta分析结果显示：腹腔镜组较开腹组手术时间短、出血少、住院天数少、胃肠功能恢复快，小肠结肠炎、便秘、污粪、狭窄、尿潴留、切口感染、肠梗阻等差异有统计学意义(P值均 < 0.05)。结论：腹腔镜Soave手术比开腹Soave手术治疗儿童先天性巨结肠创伤小，术后恢复快，能有效减少术后并发症的发生，更有助于患儿的机体恢复。

Abstract: Objective: To compare the relevant indicators of laparoscopic and open Soave surgery in the treatment of pediatric megacolon, so as to provide a reference basis for the choice of surgical methods. Methods: A literature search was conducted on PubMed, China National Knowledge Infrastructure (CNKI), Wanfang, and other databases for studies comparing the efficacy of laparoscopic Soave surgery with open Soave surgery. Relevant indicators and data on complications were extracted and analyzed using meta-analysis. Results: A total of 12 articles were included, recording 966 cases of laparoscopic Soave surgery and 744 cases of open Soave surgery for this disease. The results of the meta-analysis showed that the laparoscopic group had shorter operation time, less bleeding, fewer hospital days, faster recovery of gastrointestinal function than the open group. Differences in small bowel colitis, constipation, fecal soilage, stricture, urinary retention, incision infection, intestinal obstruction, etc., were statistically significant (P values were all < 0.05). Conclusion: Laparoscopic Soave surgery is less invasive and has a faster postoperative recovery than open Soave surgery for children with congenital megacolon. It can effectively reduce the occurrence of postoperative complications and is more beneficial for the physical recovery of children.