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      Difference of efficacy between Laparoscopic Modified Soave operation and Open Radical Resection in the treatment of Hirschsprung’s disease

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          Abstract

          Objective:

          To analyze and compare the efficacy of laparoscopic modified Soave operation and open radical resection in the treatment of Hirschsprung’s disease.

          Methods:

          Two hundred and sixteen children who suffered from Hirschsprung’s disease and were admitted into the hospital from June 2015 to December 2016 were selected as research subjects. They were grouped into an observation group in which patients were treated by laparoscopic modified Soave operation and open radical resection and a control group in which patients were treated by open radical resection. The clinical efficacy and complications of the two groups were observed, and the defecation function was also evaluated.

          Results:

          Operation indicators such as the operation time, time to recovery of intestine peristalsis, intraoperative blood loss and pain score of the observation group were superior to those of the control group, and the difference had statistical significance (P<0.05). The mean arterial pressure (MAP) and heart rate (HR) of the observation group were lower than those of the control group at all time points after operation, and the difference suggested statistical significance (P<0.05). The postoperative complications of the observation group were less than those of the control group. The follow-up results demonstrated that the excellent and good rate of Kelly score of the observation group was 81.5%, higher than 61.1% in the control group.

          Conclusion:

          Laparoscopic modified Soave operation has definite efficacy in the treatment of Hirschsprung’s disease, and the treatment is featured by high safety and few complications, which is beneficial to the recovery of defecation function; hence laparoscopic modified Soave operation is worth clinical promotion.

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          Most cited references16

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          Transanal endorectal pull-through for Hirschsprung's disease.

          A new endorectal pull-through technique using a transanal approach is presented in this report. Mucosectomy, colectomy, and pull-through are performed transanally, and neither laparotomy or laparoscopy are required. Five patients affected with Hirschsprung's disease have been operated on with this technique. During the 6- to 15-month follow-up period, all of them have had postoperative normal bowel movements.
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            Primary laparoscopic pull-through for Hirschsprung's disease in infants and children.

            Between November 1993 and September 1994, 12 primary laparoscopic colon pull-through procedures were performed in infants and children. The patients' ages ranged from 3 days to 6 years. The primary diagnosis in all 12 patients was Hirschsprung's disease. All children had their operations without construction of preoperative or postoperative colostomy. Three 5-mm abdominal wall ports were used for access to the peritoneal cavity. The sigmoid colon and proximal rectum were mobilized laparoscopically. A submucosal sleeve was developed transanally to meet the dissection from above. The colon was then pulled down in continuity, divided above the transition zone, and secured to the anal mucosa 5 to 10 mm above the pectinate line. Mean postoperative stay was 4 days. Laparoscopic visualization provides clear delineation of pelvic structures even in small infants. Laparoscopic pull-through requires no more time than similar open procedures, averaging just over 2 hours. The morbidities associated with colostomy formation and closure and the inconvenience of colostomy care are avoided with a one-stage technique. These benefits combined with the advantages of minimally invasive surgery make primary laparoscopic pull-through a potential advance in the surgical treatment of Hirschsprung's disease.
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              • Article: not found

              Laparoscopic vs open approach for transverse colon cancer. A systematic review and meta-analysis of short and long term outcomes.

              Transverse colon malignancies have been excluded from all randomized controlled trials comparing laparoscopic against open colectomies, potentially due to the advanced laparoscopic skills required for dissecting around the middle colic vessels and the associated morbidity. Concerns have been expressed that the laparoscopic approach may compromise the oncological clearance in transverse colon cancer. This study aimed to comprehensively compare the laparoscopic (LPA) to the open (OPA) approach by performing a meta-analysis of long and short term outcomes.
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                Author and article information

                Journal
                Pak J Med Sci
                Pak J Med Sci
                Pakistan Journal of Medical Sciences
                Professional Medical Publications (Pakistan )
                1682-024X
                1681-715X
                Nov-Dec 2017
                : 33
                : 6
                : 1385-1389
                Affiliations
                [1 ]Yali Tian, Department of Pediatric Surgery, Binzhou People’s Hospital, Shandong 256610, China
                [2 ]Tianting Shi, Department of General Surgery, Binzhou People’s Hospital, Shandong 256610, China
                [3 ]Fang Wang, Department of General Surgery, Binzhou People’s Hospital, Shandong 256610, China
                [4 ]Yurui Wu, Department of Minimally Invasive Surgery, Qilu Children’s Hospital of Shandong University, Shandong, 250022, China
                Author notes
                Correspondence: Yurui Wu, Department of Minimally Invasive Surgery, Qilu Children’s ospital of Shandong University 250022, Shandong, China. Email: wuyurbz@ 123456163.com
                Article
                PJMS-33-1385
                10.12669/pjms.336.13220
                5768830
                29492064
                7350de87-0590-4f15-8041-180db919fa5b
                Copyright: © Pakistan Journal of Medical Sciences

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 26 May 2017
                : 18 September 2017
                : 20 September 2017
                Categories
                Original Article

                hirschsprung’s disease,laparoscope,modified soave operation,open radical resection

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