摘要
目的比较分析全腹腔镜下美克尔憩室切除与开腹、腹腔镜辅助下美克尔憩室切除的临床疗效及并发症情况。方法对武汉协和医院2006年1月至2011年1月收治的58例美克尔憩室手术患儿进行回顾性分析。按腹腔镜技术的应用时段分成3组：全腹腔镜组13例，腹腔镜辅助组25例和开腹手术组20例，比较全腹腔镜组与其他两组的手术时间、肛门排气、排便时间、术后并发症发生率及术后住院时间。结果全腹腔镜组切口长度平均为（1．6±0．4）cm，手术时间平均为（41±5）min，肛门排气、排便时间平均为（21．2±3．7）h，术后住院时间平均为（6．3±1．2）d；腹腔镜辅助组分别为（2．5±1．2）cm、（38±2）min、（23．6±4．2）h、（6．5±2．3）d；开腹组分别为（5．0±2．2）cm、（51±6）min、（32．3±6．7）h、（8．4±3．8）d。与开腹手术组相比，全腹腔镜组和腹腔镜辅助组两组的手术时间短，并发症少、住院时间短、术后排便时间早（P〈0．05）。全腹腔镜组和腹腔镜辅助组的手术时间、住院时间及术后并发症发生率之间相比差异无统计学意义（均P〉0．05），但全腹腔镜组和腹腔镜辅助组在切口长度和术后胃肠道恢复时间之间相比差异有统计学意义（均P〈0．05）。结论全腹腔镜下切除美克尔憩室安全有效。
Objective To evaluate totally laparoscopic Meckel＇s divcrticulectomy in comparison with laparoscopic-assisted or open diverticulectomy. Methods The clinical data of 58 cases of Meckel＇s diverticulum admitted between January 2006 and January 2011 were analyzed. Cases were divided into three groups according to different period of time. As a result, totally laparoscopic surgery was performed in 13 cases, laparoscopic-assisted resection in 25 cases and open diverticuleetomy in 20 cases. Totally laparoscopic group was compared with the other two groups in operation time, flatus defecation time, the incidence of postoperative complications and postoperative hospital stay. Results The mean length of incision was （1.6 ±0. 4 ） cm, the mean operation time was （41 ＋ 5 ） min, flatus defecation time was （21.2 ＋3.7） h, and the postoperative hospital stay was （6. 3 ± 1.2） d in totally laparoscopic group. While that was （2. 5 ± 1.2 ） cm, （ 38±2 ） cm, （ 23.6 ± 4.2 ） h, （ 6. 5±2. 3 ） d, respectively in laparoscopic- assisted group, and the mean length of incision was （ 5.0 ± 2. 2） cm, the mean operation time was （ 51 ± 6） min, flatus defecation time was （32. 3± 6. 7） h, the postoperative hospital stay was （8.4 ±3. 8） d in open surgery group. Compared with conventional laparotomy, laparoscopic techniques enjoy advantages of minimal invasion, shorter operative time, fewer complications, shorter recovery period and earlier gastrointestinal recovery（ P 〈 0. 05 ）. There were no significant differences in operative time, recovery period and complications between totally laparoscopic group and laparoscopic-assisted group. Conclusions Totally laparoscopic Meckel＇s diverticulectomy is safe, effective and miniinvasive in experienced hands.
出处
《中华普通外科杂志》
CSCD
北大核心
2012年第9期733-735,共3页
Chinese Journal of General Surgery
基金
湖北省武汉市卫生局临床科研项目资助（2011WX11D10）
关键词
美克尔憩室
腹腔镜
外科手术
微创性
Meckel diverticulum
Laparoscopes
Surgical procedures, minimally invasive
