改良两孔悬吊法腹腔镜小儿阑尾切除术62例报告  

The clinical experience of modified two-port suspended laparoscopic appendectomy on children: with a report of 62 cases

作　　者：李辉[1] 黄河[1] 卞剑[1] 

机构地区：[1]安徽省立儿童医院,安徽合肥230051

出　　处：《腹腔镜外科杂志》2014年第6期457-459,共3页Journal of Laparoscopic Surgery

摘　　要：目的：探讨改良两孔悬吊法腹腔镜阑尾切除术治疗小儿急性阑尾炎的可行性、优点及注意事项。方法：回顾分析2011年6月至2012年5月采用改良两孔悬吊法腹腔镜阑尾切除术治疗62例小儿急性阑尾炎患者的临床资料。结果．62例均顺利完成改良两孔悬吊法腹腔镜阑尾切除术，手术时间平均（48±13）min，术后12—23h恢复通气。4例患儿术后2～3d右上腹切口感染。经换药、微波理疗1周后愈合。术后均无粪瘘，腹、盆腔脓肿及粘连性肠梗阻等其他并发症发生，术后平均住院（4±1）d。随访1—2年，无粘连性肠梗阻等相关并发症发生。结论：改良两孔悬吊法腹腔镜阑尾切除术治疗小儿急性阑尾炎具有创伤小、康复快、住院时间短、并发症少、安全有效等优点，但应根据术中实际情况操作，切不可盲目追求微创。Objective：To explore the feasibility, advantages and precautions of modified two-port suspended laparoscopic appendectomy in the treatment of pediatric acute appendicitis. Methods ： The clinical data of 62 children who suffered from acute appendicitis and underwent modified two-port suspended laparoscopic appendectomy from Jun. 2011 to May 2012 were retrospectively analyzed. Results ： Modified two-port suspended laparoscopie appendectomy was successfully operated in all the 62 cases. The mean operation time was （48 ± 13） min. The ventilation time was 12-23 h after surgery. Incision infection occurred in 4 cases in the right upper quadrant, and was cured by dressing change and microwave therapy for 1 week. None children had postoperative fecal fistula, abdominal or pelvic abscess, adhesive intestinal obstruction or other complications. The mean postoperative hospital stay was （4 ± 1 ） d. The children were followed up for 1-2 year, no adhesive intestinal obstruction or any other related complications occurred. Conclusions：Modified two-port suspended laparoscopic appendectomy is safe and effective in the treatment of pediatric acute appendicitis, has advantages of less trauma, faster recovery, shorter hospital stay, and fewer complications. However, surgery should be performed based on the actual situation in the operation and surgeons should not blindly pursue minimal invasion.

关 键 词：阑尾炎 阑尾切除术 腹腔镜检查 两孔法 儿童 

分 类 号：R726.5[医药卫生—儿科]