腹腔镜诊断治疗小儿胃重复畸形4例  

Laparoscopic Diagnosis and Treatment of Gastric Duplication in Children

作　　者：刘垚[1] 李龙[2] 侯文英[2] 董宁[2] 

机构地区：[1]北京协和医学院研究生院,北京100730 [2]首都儿科研究所外科,北京100020

出　　处：《中国微创外科杂志》2012年第2期145-148,共4页Chinese Journal of Minimally Invasive Surgery

基　　金：北京市科技计划课题(D101100050010064)

摘　　要：目的探讨腹腔镜诊断治疗小儿胃重复畸形的可行性。方法 2006年6月～2011年6月,腹腔镜诊断治疗胃重复畸形4例。术前B超或CT检查均无法明确诊断,经腹腔镜探查术中确诊。胃体表面的胃重复畸形,采用腹腔镜辅助脐孔拖出方式切除;若胃重复畸形位于胃后壁,则利用腹壁悬吊牵引技巧,牵开胃肠组织,获得良好的显露,完全腹腔镜下切除后壁囊肿。结果腹腔镜辅助脐孔拖出切除2例,完全腹腔镜下切除2例。4例均顺利完成手术。手术时间100～135min,平均119 min;术中出血量5～25 ml;均无术中、术后并发症。分别随访3个月、2年、3年、3年,术前症状完全消失,恢复好。结论腹腔镜在胃重复畸形,特别是非复杂的囊肿型胃重复的诊断和治疗方面有重要价值。Objective To investigate the feasibility of laparoscopic diagnosis and treatment of gastric duplication in children. Methods From June 2006 to June 2011, four cases of gastric duplication were diagnosed and treated by laparoscopy in our hospital. Their diagnosis could not be confirmed by uhrasonography or CT scan until laparoscopic exploration. The gastric duplication, lying on the front part of the gastric body, was removed by transumbilical laparoscopic-assisted approach. If the duplication was located behind the gastric body, transabdominal wall suspension was employed to move the stomach or bowel so that to obtain good exposure and resect the cyst at the posterior wall completely. Results Among the four cases, two children underwent the laparoscopic resection by pulling out the lesion via the umbilicus, while the other two operations were completed totally by laparoscopic-assisted approach. All the four cases were uneventful. Operation time ranged from 100 to 135 minutes with a mean of 119 minutes. The amount of blood loss was 5 - 25 ml. All patients recovered uneventfully without any complications. Follow-up was achieved for 3 months, 2 years, 3 years and 3 years, respectively, all the children had recovered completely. Conclusion Laparoscopic diagnosis and treatment are valuable for gastric duplications, especially for uncomplicated gastric duplication cysts.

关 键 词：胃重复畸形 腹腔镜 治疗 

分 类 号：R726.5[医药卫生—儿科]