小儿腹腔镜阑尾切除术中腹腔探查的临床意义  

Clinical significance of abdominal exploration in pediatric laparoscopic appendectomy

作　　者：阿布都赛米.阿布都热依木 卡热也木[1] 玉苏甫[1] 李凯[1] 刘东[1] 和军[1] 阿孜古丽[1] 周玲[1] 李水学[1] 克力木[1] 

机构地区：[1]新疆维吾尔自治区人民医院,新疆乌鲁木齐830001

出　　处：《腹腔镜外科杂志》2017年第4期296-299,共4页Journal of Laparoscopic Surgery

摘　　要：目的:探讨小儿腹腔镜阑尾切除术(laparoscopic appendectomy,LA)中常规腹腔探查诊治小儿合并疾病的临床意义。方法:720例急慢性阑尾炎患儿行LA前常规探查,按顺序探查腹腔、盆腔脏器。如发现合并其他疾病同时进行处理。结果:本组腹腔镜术中常规探查腹盆腔发现腹股沟隐性疝63例(8.75%),同时行内环口关闭术;发现小肠憩室21例(2.92%),同时行腹腔镜辅助小肠憩室切除、肠吻合术;同侧附件囊肿36例(5.0%),对侧附件囊肿8例(1.11%),双侧附件囊肿12例(1.67%),右侧卵巢畸胎瘤6例(0.83%),同时行切除术;肠系膜囊肿2例,行囊肿切除术;右侧输卵管脓肿1例,同时行引流术。结论:小儿LA已是成熟、安全的术式,术中常规进行腹盆腔探查,如发现外科干预的疾病可同时进行有效处理,避免了因其他疾病行二次麻醉及手术的痛苦,减少了医疗费用。Objective ： To explore the clinical significance of routine abdominal exploration in laparoscopic appendectomy （LA） for pediatric medical comorbidities. Methods ： Routine abdominal exploration before LA was performed for 720 children with acute or chronic appendicitis, abdominal cavity and pelvic cavity were sequentially explored. If comorbidities were found, they were treated at the same time. Results：All cases were performed conventional laparoscopic surgery with abdominal and pelvic exploration, hidden inguinal hernia was found in 63 cases （8.75 % ） , closure of inguinal inner ring was performed. Small intestinal diverticula was found in 21 cases （2.92%） , resection of small intestine diverticulum and intestinal anastomosis was performed for them. lpsilateral adnexal cyst was found in 36 cases （5.0%） ,contralateral adnexal cyst was found in 8 cases （1.11%） ,bilateral adnexal cysts were found in 12 cases （ 1.67% ） ,right ovarian teratoma in 6 cases （0.83%） ,all the lesions were resected. Mesenteric cyst was found in 2 cases and resected. Right tubal abscess was found in 1 case, drainage was applied. Conclusions：Currently pediatric LA is very mature and safe surgical procedure. Routine abdominal and pelvic exploration can find diseases which should be operated and treat them at the same time, avoid unnecessary anesthesia, surgical trauma and medical costs.

关 键 词：阑尾切除术 腹腔镜检查 腹腔探查 儿童 

分 类 号：R726.5[医药卫生—儿科]