腹腔镜辅助十二指肠-空肠吻合术治疗肠系膜上动脉综合征  

Laparoscopy-assisted Roux-en-Y duodenojejunostomy for superior mesenteric artery syndrome

作　　者：仲智勇[1] 李索林[1] 时保军[1] 徐伟立[1] 于增文[1] 李英超[1] 

机构地区：[1]河北医科大学第二医院小儿外科,石家庄050000

出　　处：《中华小儿外科杂志》2010年第10期739-741,共3页Chinese Journal of Pediatric Surgery

基　　金：国家十一五科技支撑计划项目（编号：2006BAI05A06）

摘　　要：目的 评价腹腔镜治疗小儿肠系膜上动脉综合征的效果.方法 2003年5月至2009年12月,采用腹腔镜辅助十二指肠-空肠Roux-en-Y吻合术治疗9例肠系膜上动脉综合征.男3例,女6例,年龄6～13岁.采用4个Trocar,腹腔镜下松解Treitz韧带,扩大脐部切口,将空肠提出离断后完成近端与远端空肠吻合;回纳空肠,将预留空肠袢在横结肠后与十二指肠扩张段腹腔镜下行Roux-en-Y吻合.结果 手术全部顺利完成,手术时间2～3.5 h,出血量（15.2±3.0））ml.术后随访5个月～6年无症状,生长发育良好.结论 腹腔镜辅助十二指肠-空肠Roux-en-Y吻合术是一种安全有效的方法,具有损伤小、住院时间短和并发症少等特点.Objective To evaluate the effectiveness of laparoscopy-assisted Roux-en-Y duodeno- jejunostomy for superior mesenteric artery syndrome. Methods From May 2003 to December 2009, 9 children （ age range： 6 to 13 years） with superior mesenteric artery syndrome underwent laparoscopic Roux-en-Y duodenojejunostomy. Among them, 3 were boys and 6 girls. The procedure was performed using 4 trocars. TreitZs ligament was dissected first, and the jejunojejunal anastomosis was achieved by exteriorizing the proximal jejunum through the umbilical incision. Then, the retrocolic Roux-en-Y duodenojejunostomy was carried out laparoscopically. Results All procedures were completed successfully. Operative time was 2 to 3. 5 h, and the blood loss was （15.2± 3） ml. The patients had complete resolution of their preoperative symptoms and a normal growth and development at 5-72 months follow-up. Conclusions Laparoscopic Roux-en-Y duodenojejunostomy is a safe technique for the superior mesenteric artery syndrome. It has the benefits of less post-operative pain, a shorter hospital stay, and less postoperative disability.

关 键 词：腹腔镜外科手术 吻合术 Roux-en-Y 肠系膜上动脉综合征 

分 类 号：R686[医药卫生—骨科学]