摘要
目的探讨经脐双通道及耻骨联合上操作孔行腹腔镜小儿肠套叠复位术的可行性。方法回顾性分析广州市番禺区何贤纪念医院26例小儿肠套叠患者的临床资料,通过经脐双通道(脐下缘做5 mm观察孔,脐上缘做3 mm操作孔)加做耻骨联合上3 mm操作孔,行腹腔镜肠套叠复位术;并对治疗效果进行分析,检验该方法是否可行。结果 26例均顺利完成腹腔镜肠套叠复位术,无复位失败中转开腹患者。术中发现回肠结肠型肠套叠20例,回肠回肠结肠型肠套叠6例。术中同时行阑尾切除术10例;术中发现合并腹股沟斜疝,同时行疝囊高位结扎术4例,行回盲部折叠固定6例;患儿均在术后24 h内恢复肛门排气、排便;术后24 h内恢复进流食;术后无严重并发症出现,恢复良好,住院时间3~5 d。结论经脐双通道及耻骨联合上操作孔行腹腔镜小儿肠套叠复位术,Trocar位置分布合理,操作起来更方便、灵活且更安全,Trocar不易滑脱;能完成较复杂的手术操作;术后瘢痕更小、更隐蔽、更美观;手术安全可行,极具推广价值。
Objective To investigate the feasibility of reduction intussusception by laparoscopie surgery transumbilical double channel and suprapubic hole. Methods The clinic data of 26 cases of the intussusception in children who implement the laparoscopic was retrospective analysed,laparoseopie reduction was impelmented in all the patient. Double channel through the umbilical cord （supraumblic port （3 mm） and subumblie port （5 ram） and above synehondroses pubis port（3 ram）. Results All the patient were finished the laparoscopic surgery without conversion of the open laparotomy, including 20 cases of ileocolic , 6 cases of ileoileo-colic, the appenditomy were carried out in 10 eases, and high ligation of the hernia sac was performed who was found inguinal hernia during operation in 4cases, ileocecal junction was folded and fixed in 6 cases, there were no complications occurred in all the patient, all the patients recoveried bowel movement in 24 hours and started liquid diet. the hospital time was about 3-5 days. Conclusions Transumbilical double channel and suprapubic hole laparoscopic operation in pediatric intussusception reduction is safe and feasibility , this operation has some strengthes ： simple, safe, reasonable, mininal invasive.
出处
《中华腔镜外科杂志（电子版）》
2017年第1期57-59,共3页
Chinese Journal of Laparoscopic Surgery(Electronic Edition)
基金
广州市番禺区科研项目(2014-Z03-37)
关键词
腹腔镜
肠套叠
经脐双通道
耻骨联合
回盲部折叠固定
Laparoscopy
Intussusception
Double channel through the umbilical cord
Synchondroses pubis
Folding and fixing of ileocecal junction
