目的 探讨经脐单切口腹腔镜技术在小儿急性阑尾炎诊断和治疗的安全性及可靠性。方法 回顾2013-03至2015-03收治的小儿急性阑尾炎112例病历资料,分为经脐单切口与传统腹腔镜诊断和手术治疗两组。手术时年龄为生后2 h～16岁,平均随访时间13.7个月(3～24个月),其中单纯性阑尾炎28例,化脓性阑尾炎58例,坏疽阑尾炎26例。结果 通过比较单切口腹腔镜组及传统腹腔镜组治疗小儿阑尾炎,手术时间前者较后者有明显缩短[(35.9±10.0)min vs (41.7±15.1)min,P<0.05],在术中出血量、术后肠功能恢复时间、住院时间、术后并发症方面两组差异无统计学意义。结论 经脐单切口腹腔镜技术是诊断、治疗小儿急性阑尾炎的安全、可靠的方法,术后近期疗效满意,为小儿急诊外科诊治提供了新的途径。
Abstract
Objective To describe the technique and evaluate the outcome of singleincision laparoscopic approach for acute appendicitis in children. Methods 112 Children with acute appendicitis who underwent single-incisionlaparoscopic surgery or conventional laparoscopic surgery between March 2013 and March 2015 were reviewed. Mean age at operation were 2 h～16 years. The mean follow-up period was 13.7 months (range, 3 to 24months). 28 acute simple appendicitis, 58 suppurativeappendicitis and 26 gangrenous appendicitis were included. Results All cases underwentsingle-incision laparoscopic surgery or conventional laparoscopic surgerysuccessfully. Mean operation time was decreased in single-incision laparoscopicsurgery group (P<0.05). There was no significant difference between the 2groups in intraoperative blood loss, postoperative complication andpostoperative stay.Conclusions Singleincision laparoscopic approach for hernia of acute appendicitis is a safe andeffective, minimally invasive new technology.
关键词
阑尾炎 /
经脐单切口 /
腹腔镜 /
小儿急诊外科
Key words
appendicitis /
single incision laparoscopic approach /
pediatric emergency surgery
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1]Rothenberg S S, Shipman K, Yoder S. Experience with modified single-port laparoscopic procedures in children[J]. J Laparoendosc Adv Surg Tech A,2009,19(5):695-698.
[2] Hansen E N, Muensterer O J, Georgeson K E, et al. Single-incision pediatric endosurgery: lessons learned from our first 224 laparoendoscopic single-site procedures in children[J]. Pediatr Surg Int,2011,27(6):643-648.
[3] Chow A, Purkayastha S, Paraskeva P. Appendicectomy and cholecystectomy using single-incision laparoscopic surgery (SILS): the first UK experience[J]. Surg Innov,2009,16(3):211-217.
[4] Tam Y H, Lee K H, Sihoe J D, et al. Initial experience in children using conventional laparoscopic instruments in single-incision laparoscopic surgery[J]. J Pediatr Surg,2010,45(12):2381-2385.
[5] Diao M, Li L, Dong N, et al. Single-incision laparoscopic Roux-en-Y hepaticojejunostomy using conventional instruments for children with choledochal cysts[J]. Surg Endosc, 2012,26(6):1784-1790.
[6] Zhang J S, Li L, Diao M, et al. Single-incision laparoscopic excision of pancreatic tumor in children[J]. J Pediatr Surg, 2015,50(5):882-885.
[7] 张 军,葛军涛,魏延栋,等.单孔腹腔镜治疗小儿腹股沟嵌顿斜疝的探讨[J].中国微创外科杂志,2014,14(9):769-771.
[8] 陈开运,向国安,王汉宁,等.腹腔镜与开放手术治疗急性阑尾炎的疗效比较[J].中华普通外科杂志,2010,25(4):295-298.
[9] 余东海,张 文,冯杰雄,等.经脐腹腔镜与传统腹腔镜治疗小儿急性阑尾炎的比较研究[J].中华小儿外科杂志,2011,32(10):749-752.
[10] 李永超,王甲天,崔明福,等.腹腔镜与开腹手术治疗急性阑尾炎穿孔的比较[J].中国微创外科杂志,2014,(4):327-330.
PDF(534 KB)
