Abstract：
Background: Surgical correction is the main line of treatment for the congenital disorder Hirschsprung\'s disease (HD). Laparoscopic techniques proved their safety and efficacy in previous studies. LigaSure™ is the gold standard for colorectal dissection. However, other sealing methods could be used during the unavailability of LigaSure. Purpose: This study aimed to assess the safety profile of the hook diathermy technique compared to LigaSure in colorectal dissection during laparoscopic-assisted pull-through for HD. Materials and Methods: This case-control study was held in the pediatric surgery department at Assiut University Hospitals between September 2017 and January 2023. The study included 57 HD patients who were surgically operated on during a laparoscopic-assisted pull-through. They were divided into 2 groups according to the sealing methods: the ligasure group included 25 patients, and the hook diathermy group included 32 patients. Results: Both groups had no statistically significant differences regarding age, sex, or weight. The transition zone was present in all patients, and most transition zones were rectosigmoid. No cases reported intraoperative blood transfusion or conversion to an open or transanal approach. Minimum intraoperative blood loss was reported in both groups, with no significant differences. As regards postoperative complications, including bleeding, leakage, perianal excoriation, and enterocolitis, no significant differences between both groups were found. Conclusion: The LigaSure and hook diathermy techniques are safe and effective sealing methods for colorectal dissection during laparoscopic-assisted pull-through for HD.
摘要：
背景：手术矫正是先天性先天性巨结肠病（HD）的治疗主线。腹腔镜技术在先前的研究中证明了其安全性和有效性。LigaSure™是结直肠夹层的黄金标准。然而,在LigaSure不可用期间，可以使用其他密封方法。目的：本研究旨在评估在腹腔镜辅助穿刺治疗HD期间，与LigaSure相比，钩透热技术在结直肠夹层中的安全性。材料和方法：本病例对照研究于2017年9月至2023年1月在阿西特大学医院小儿外科进行。该研究包括57例HD患者，他们在腹腔镜辅助穿刺期间接受了手术。根据密封方法分为2组：齐性治疗组包括25例患者，钩子透热疗法组包括32名患者。结果:两组患者年龄差异无统计学意义,性别,或体重。过渡区存在于所有患者中，过渡区大部分为乙状结肠。没有病例报告术中输血或转换为开放或经肛门入路。两组均报告了术中最小失血量，没有显著差异。至于术后并发症，包括出血,泄漏,肛周摘除,小肠结肠炎,两组间无显著差异.结论：LigaSure和Hook透热技术是腹腔镜辅助下结直肠夹层手术中安全有效的封闭方法。
