直线切割吻合器在儿童腹腔镜胆总管囊肿根治术Roux-en-Y吻合中的应用  

Application of linear cutting stapler in Roux-en-Y during laparoscopiccholedochal cyst radical surgery in children

作　　者：刘登辉[1] 李勇[1] 黎明[1] 唐湘莲[1] 黄召[1] 向强兴 周宇翔[1] Liu Denghui;Li Yong;Li Ming;Tang Xianglian;Huang Zhao;Xiang Qiangxing;Zhou Yuxiang(Department of General Surgery,Hunan Children's Hospital,Changsha 410007,China)

机构地区：[1]湖南省儿童医院普外科,长沙410007

出　　处：《临床小儿外科杂志》2024年第3期238-241,共4页Journal of Clinical Pediatric Surgery

基　　金：湖南省临床医疗技术创新引导项目(2020SK50501);湖南省自然科学基金-面上项目(2023JJ30323);湖南省儿童实体瘤临床医学研究中心项目(2023SK4058)

摘　　要：目的探讨直线切割吻合器应用于儿童腹腔镜胆总管囊肿根治术Roux-en-Y吻合中的有效性、安全性及可行性。方法本研究为前瞻性研究,选取2020年1月至2023年1月湖南省儿童医院接受腹腔镜胆总管囊肿根治术Roux-en-Y吻合的34例患儿作为研究对象,按照随机数字表法进行分组,采用直线切割吻合器实施Roux-en-Y吻合术的患儿纳入观察组(n=17),采用传统缝合法实施Roux-en-Y吻合术的患儿纳入对照组(n=17)。记录两组患儿手术时长、术中出血量、术后肠道功能恢复时间、首次进食流质时间、拔除引流管时间、术后住院时间、总住院费用和术后并发症发生率。结果34例均顺利完成手术,无一例中转开放手术。观察组与对照组手术时长[(130.43±31.32)min比(141.51±30.39)min]、术中出血量[(55.45±20.73)mL比(58.62±22.13)mL]差异均无统计学意义(P>0.05);观察组与对照组患儿术后肠道功能恢复时间[(4.03±0.42)min比(4.91±1.13)min]、首次进食流质时间[(3.95±0.61)d比(4.88±1.09)d]、拔除引流管时间[(5.95±0.68)d比(6.65±1.28)d]、术后住院时间[(8.29±2.17)d比(10.33±2.18)d]均短于对照组,差异均有统计学意义(P<0.05);观察组与对照组患儿总住院费用[(34948.17±1019.57)元比(35151.91±1151.15)元]、并发症发生率(1/17比2/17)差异无统计学意义(P>0.05)。结论直线切割吻合器在儿童腹腔镜胆总管囊肿根治术Roux-en-Y吻合中与传统缝合吻合技术的有效性和安全性无明显差异,可促进患儿术后恢复,值得临床推广应用。Objective To explore the clinical efficacy,feasibility and safety of linear cutting stapler in Roux-en-Y during laparoscopic choledochal cyst radical surgery in children.Methods Between January 2020 and January 2023,34 children undergoing Roux-en-Y after choledochal cyst radical surgery were enrolled.They were randomized into two groups of control(n=17)and observation(n=17).Control group underwent Roux-en-Y with traditional sutured method,while observation group underwent Roux-en-Y with linear cutting stapler.The operation time,intraoperative blood loss,postoperative intestinal function recovery time,initial feeding time,removal time of drainage tube,postoperative hospitalization stay,total hospitalization expense and postoperative complication rate in two groups were compared.Results All operations were successful without any conversion.Operative duration[(130.43±31.32)vs.(141.51±30.39)min]and intraoperative volume of blood loss[(55.45±20.73)vs.(58.62±22.13)mL]had no statistical differences.As compared with control group,observation group was shorter with regards to time of postoperative intestinal function recovery[(4.03±0.42)vs.(4.91±1.13)min],initial feeding time[(3.95±0.61)vs.(4.88±1.09)day],removal time of drainage tube[(5.95±0.68)vs.(6.65±1.28)day]and postoperative hospitalization stay[(8.29±2.17)vs.(10.33±2.18)day](P<0.05).During a follow-up period of 6 months,no significant inter-group difference existed in total hospitalization expense[(34948.17±1019.57)vs.(35151.91±1151.15)yuan]or the incidence of complications[1/17 vs.2/17](P>0.05).Conclusions Linear cutting stapler has the same effectiveness and safety as traditional suturing techniques in Roux-en-Yin laparoscopic choledochal cyst radical surgery in children,and is worth it of clinical promotion and application.

关 键 词：胆总管囊肿 腹腔镜 ROUX-EN-Y 直线切割吻合器 外科手术 儿童 

分 类 号：R726.5[医药卫生—儿科]