RESUMO
Objective:To investigate and compare the therapeutic effect of Foley catheter balloon dilation and the traditional open reduction in the treatment of intussusception in children.Methods:A total of 68 children with intussusception treated by Foley catheter balloon dilatation by laparoscopic surgery or traditional open reduction in Department of Pediatric Surgery, the Second Hospital of Lanzhou University from August 2015 to July 2019 were retrospectively analyzed.Among them, there were 32 cases in the Foley catheter group and 36 cases in the traditional laparotomy group.Foley catheter group were treated with laparoscopic Foley catheter balloon dilatation, while the traditional open group were treated with traditional open surgery which was performed with finger dilatation.The results of surgical treatment, postoperative recovery, short-term complications, patient satisfaction and long-term complications were compared between the two groups.Results:Among the indexes of surgical treatment effect, the operation time[(0.4±1.1) h], intraoperative bleeding volume[(10.2±3.4) mL], incision size[(0.5±0.4) cm] and incidence of the rupture of intestine[6.3%(2/32 cases)] in the Foley catheter group were significantly lower than those in the traditional open group[(1.3±2.9) h, (40.5±2.1) mL, (5.1±0.7) cm, 30.6%(11/36 cases)], and the differences were statistically significant (all P< 0.05). Among the indexes of postoperative recovery and short-term complications, recovery time of gastrointestinal function[(1.2±3.1) d], length of hospital stay[(6.7±1.8) d], incidence of incision infection[9.4%(3/32 cases)]and incidence of incisional hernia(0) in the Foley catheter group were significantly lower than those in the traditional open group[(3.3±6.4) d, (7.3±0.9) d, 36.1%(13/36 cases), 16.7%(6/36 cases)], and the differences were statistically significant (all P<0.05). Among the indexes of family satisfaction and long-term complications, the score of family satisfaction in the Foley catheter group [(8.7±1.2) scores]was significantly higher than that in the traditional open group[(6.6±3.1) scores], and the incidence of adhesive intestinal obst-ructionin the Foley catheter group (0)was significantly lower than that in the traditional open group[0 vs.19.4%(7/36例)], and the differences were statistically significant(all P<0.05). Conclusions:Compared with traditional open reduction in the treatment of intussusception in children, Foley catheter balloon dilation has the advantages of short operation time, safe operation, low incidence of intestinal injury, less bleeding, and so on, and also has the advantages of small incision, fast recovery, short hospitalization time, high satisfaction of parents.In addition, the Foley catheter balloon dilation has a lower incidence of incisional infection, incisional hernia, postoperative intestinal adhesion and other complications.
RESUMO
ObjectiveTo assess the effectiveness and prognosis of different radical surgery for Hirschsprung disease (HD).MethodsThe bowel function of HD patients undergoing the anus modified Soave operation (84 cases,modified Soave group),modified Swenson operation (60 cases,modified Swenson group),modified Duhamel operation (76 cases,modified Duhamel group) was followed up by 3,6 months and 2 years after surgery.Long-term bowel function,clinical type,removal length,anorectal manometry,barium enema were analyzed and compared among three groups.ResultsThe occurrence rates of bowel dysfunction 3,6 months and 2 years after surgery in modified Soave group[17.9％(15/84),7.1％(6/84),4.8％ (4/84)] were significantly lower than those in modified Swenson group[41.7％ (25/60),21.7％(13/60),18.3％(11/60) ] and modified Duhamel group [ 36.8％ (28/76),18.4％ (14/76),13.2％(10/76) ].There was significant difference between modified Soave group and modified Swenson group,modified Duhamel group(P＜ 0.05 ).There was no significant difference between modified Swenson group and modified Duhamel group (P ＞ 0.05).When the removal length ≤35 cm,the occurrence rate of bowel dysfunction after surgery in modified Soave group [ 18.7％ (14/75)] was lower than that in improved Swenson group [ 39.5％ ( 17/43 ) ] and modified Duhamel group [ 34.4％ (21/61 ) ].There was significant difference between modified Soave group and modified Swenson group,modified Duhamel group (P ＜ 0.05).There was no significant difference between modified Swenson group and modified Duhamel group (P ＞ 0.05).When the removal length ＞ 35 cm,there was no significant difference in the occurrence rate of bowel dysfunction after surgery among three groups (P ＞ 0.05 ).The occurrence rates of bowel dysfunction in short-segment type and common type in modified Soave group was lower than those in modified Swenson group and modified Duhamel group.There was significant difference between modified Soave group and modified Swenson group,modified Duhamel group(P ＜ 0.05).There was no significant difference between modified Swenson group and modified Duhamel group (P＞ 0.05).The anorectal angle 2 years after surgery in modified Soave group [(93.67 ± 10.50)° ] was less than that in modified Swenson group [(110.20 ± 11.88)° ] and modified Duhamel group [(106.33 ± 12.21)° ].There was significant difference (P ＜0.05).ConclusionThe complication and trauma are significantly lower in the anus modified Soave operation than the modified Swenson operation and modified Duhamel operation,but the choice of surgery should be strictly controlled according to the anal HD treatment indications.