腹腔镜手术治疗小儿肠套叠12例  

Laparoscopic Surgery of Intussusception in Children:Report of 12 Cases

作　　者：李贵斌[1] 邱云[1] 李龙[2] 宋连杰[1] 赵卫斌[1] 陈瑜峰[1] 王利[1] 

机构地区：[1]天津市第五中心医院小儿外科,天津300450 [2]首都儿科研究所外科,北京100020

出　　处：《中国微创外科杂志》2008年第9期781-782,共2页Chinese Journal of Minimally Invasive Surgery

基　　金：天津市塘沽区科技发展资金(项目编号:2007CG18-02)

摘　　要：目的探讨腹腔镜手术治疗小儿肠套叠的价值。方法2004年1月～2007年1月,对空气灌肠复位失败或反复发作多次(≥3次)的小儿肠套叠,采用腹腔镜三孔法手术,腹腔镜下将回肠末端与升结肠平行排列、浆肌层手工间断缝合3针,回盲部与右侧腹后壁间断缝合固定2～3针(空气灌肠复位失败的患儿)。结果术中出血量20～60 ml,手术时间45～90 min。术后无吻合口漏,胃肠道功能恢复良好。12例术后随访1～5年,平均2年9个月,无复发,患儿发育良好,进食排便均正常。结论腹腔镜手术治疗小儿肠套叠,恢复快,术后并发症少。Objective To evaluate the value of laparoscopic surgery application in treating intussusception. Methods Between January 2004 and December 2007, 12 children with refractory （8 cases, failed air enema） or recurrent （for over 3 times） intussusception received laparoscopic surgery in our hospital. Three trocars were used during the surgery. Under a laparoscope, by interrupted suture, the terminal ileum was joined to the ascending colon （3 stitches） , and the ileocecal junction was fixed to the right posterior abdominal wall （2 to 3 stitches, only for children that failed air enema）. Results The intraoperative blood loss ranged from 20 to 60 ml, and the operation lasted for 45 to 90 minutes. No patient developed anastomotic leakage or abnormal gastrointestinal function. The patients were followed up for 1 to 5 years （mean, 2 years and 9 months） , during which none of them had recurrence. The children had normal intake and excretion, and developed well. Conclusions Children with intussusception recover quickly after laparoscopic treatment with a few postoperative complications.

关 键 词：腹腔镜 小儿 肠套叠 

分 类 号：R726.5[医药卫生—儿科]