摘要
目的 探讨经脐双孔法腹腔镜手术在小儿外科中应用的可行性。 方法 2 0 0 3年 1月～ 2 0 0 3年 12月应用微型腹腔镜对 6 0例小儿腹股沟斜疝 (年龄 3个月～ 14岁 ,平均 3 5岁 ) ,4 0例小儿阑尾炎 (年龄 2 5～ 14岁 ,平均 6 3岁 )行疝囊超高位结扎和阑尾切除术。疝囊超高位结扎术于脐轮左右侧分别置腹腔镜和操作钳 ,内环口体表投影处进带线的疝环针 ,体外打结。阑尾切除术在右麦氏点戳孔置操作器械 ,术中同时探查有无对侧疝或其它消化道畸形疾病。 结果 手术经过顺利 ,每侧疝和阑尾炎的平均手术时间 8 5min和 5 5 7min。小儿腹股沟斜疝术后 1～ 2d出院 ,阑尾炎术后 5～ 7d出院。经 3～ 12个月随访 ,除 1例隐性疝术中漏诊术后 2个月发生疝外 ,未见疝复发 ;2例阑尾穿孔术后合并腹腔感染 ,余患儿术后恢复顺利。 结论 经脐双孔法腹腔镜手术操作简易 ,安全有效 ,创伤小 ,并发症少 ,切口更加美观 ,值得在小儿外科推广应用。
Objective To evaluate the feasibility of trans-umbilicus two-port laparoscopic procedures in pediatric surgery.Methods Sixty children (age, 3 months～14 years; mean, 3.5 years) with indirect inguinal hernia and 40 children (age, 2.5～14 years; mean, 6.3 years) with appendicitis underwent supra-high ligation and appendectomy, respectively, by using mini laparoscope from January 2003 to December 2003. During the supra-high ligation, the camera and forceps were respectively introduced via the left and right side of umbilical ring, and a hernial-ring needle with suture was brought in at the site of body surface projection of internal ring to apply external knotting. During the appendectomy, laparoscopic instruments were put through the site of right McBurney’s point, and explorations for contralateral hernia or other digestive tract malformations were applied simultaneously. Results All the operations were completed smoothly. The mean operating time was 8.5 min and 55.7 min in hernia repair (per side) and appendectomy, respectively. The mean postoperative hospital stay was 1～2 days in children with indirect inguinal hernia and 5～7 days in children with appendicitis. Follow-up for 3～12 months showed no recurrence of hernia except for 1 case of intraoperatively misdiagnosed latent hernia, which relapsed 2 months after the surgery. Postoperative abdominal cavity infection took place in 2 cases of perforated appendicitis. Conclusions Trans-umbilicus two-port laparoscopic technique is simple to perform, safe and minimally invasive. The technique has fewer complications and gives satisfactory cosmetic results, being highly recommended.
出处
《中国微创外科杂志》
CSCD
2004年第3期216-217,共2页
Chinese Journal of Minimally Invasive Surgery
关键词
腹腔镜
腹股沟斜疝
阑尾切除术
儿童
双孔法
Laparoscope
Indirect inguinal hernia
Appendectomy
Children
Two-port technique
