经脐单部位与传统腹腔镜手术治疗新生儿肠旋转不良的比较研究  

Comparison of effective Between transumbilical single site and traditional laparoscopic surgery for neonatal intestinal Malrotation

作　　者：刘智文[1] 陈快[1] 陶俊峰[1] 樊纬[1] 黄金狮[1] 陶强[1] LIU Zhi-wen;CHEN Kuai;TAO Jun-feng(Department of Neonatal Surgery,Jiangxi Children’s Hospital,Nanchang 330006,China)

机构地区：[1]江西省儿童医院新生儿外科

出　　处：《江西医药》2019年第7期731-732,784,共3页Jiangxi Medical Journal

摘　　要：目的探讨经脐单部位腹腔镜治疗新生儿肠旋转不良手术的安全性和可行性.方法回顾性分析2010年1月-2018年6月行腹腔镜下ladd术治疗新生儿先天性肠旋转不良110例的临床资料,2014年12月前使用传统多部位三孔法64例(多部位组),以后采用经脐单部位切口46例(经脐组).比较2组手术时间、术后并发症、初次进食时间、住院时间.结果经脐组手术时间为(85.3±26.4)min,多部位组手术时间为(83.6±20.5)min;术后进食时间经脐组为(57.9±27.8)h,多部位组为(66.5±27.4)h;住院时间经脐组为(13.1±4.3)d,多部位组为(13.4±4.3)d;经脐组2例中转开腹,多部位组5例中转开腹;术后粘连、穿孔等并发症,经脐组为4例、再手术3例,多部位组为5例、再手术4例;两组各项指标对比均无显著差异.结论经脐单部位腹腔镜治疗肠旋转不良与传统多部位三孔法同样安全有效,并且术后腹部切口隐匿.Objective To evaluate the safety and feasibility of transumbilical single site laparoscopy in the treatment of neonatal malrotation of intestine. Methods Retrospective analysis was performed on the clinical data of 110 cases of congenital malrotation of the intestine in newborns treated with ladd under laparoscope from January 2010 to June 2018, 64 cases were treated with traditional multi-site three-hole method (multi-site group) before December 2014, and 46 cases were treated with single-site incision via umbilicus (transumbilical group) later. Operation time, postoperative complications, time of first feeding and hospital stay were compared between the two groups. Results Operation time was (85.3±26.4) min in the transumbilical group and (83.6±20.5) min in the multi-site group. Postoperative feeding time was (57.9±27.8) h in the umbilical group and (66.5±27.4) h in the multi-site group. The length of stay was (13.1±4.3) d in the umbilical group and (13.4±4.3) d in the multi-site group. 2 cases in the transumbilical group were transferred to laparotomy, 5 cases in the multi-site group were transferred to laparotomy. Postoperative complications such as adhesion and perforation included 4 cases in the transumbilical group and 3 cases with reoperation,5 cases in the multi-site group and 4 cases with reoperation. There was no significant difference between the two groups.Conclusion The treatment of intestinal malrotation by transumbilical single site laparoscope is as safe and effective as the traditional multi-site three hole method, and the abdominal incision is hidden after operation.

关 键 词：肠旋转不良 腹腔镜 经脐单部位 

分 类 号：R726.5[医药卫生—儿科]