腹腔镜下根部缝扎法在梅克尔憩室切除中的应用研究  

Study of laparoscopic basal ligation in the treatment of Merkel’s diverticulum

作　　者：李钰坤 叶镇彭[1] 黄荏安 王立勇[1] 黄立平 李泽民 邓志权 LI Yu-kun;YE Zhen-peng;HUANG Ren-an(Department of Pediatric Surgery,Dongguan People's Hospital,Dongguan 523000,China)

机构地区：[1]东莞市人民医院小儿外科,523000

出　　处：《中国现代药物应用》2022年第23期23-26,共4页Chinese Journal of Modern Drug Application

摘　　要：目的 分析腹腔镜下根部缝扎法行梅克尔憩室(MD)切除术的安全性和可行性。方法 选取42例经手术及病理检查确诊的梅克尔憩室患儿,根据手术方式不同分为研究组(20例)与对照组(22例)。研究组行腹腔镜下根部缝扎法切除,对照组行传统腹腔镜辅助下经脐部切口提出行憩室切除的肠吻合术。回顾性分析两组临床资料,比较两组临床指标,包括住院时间、手术时间、切口总长度、术中出血量、下床活动时间、术后肠鸣音恢复时间、术后肛门排气时间、术后进食时间、并发症(腹部并发症、腹外并发症、切口感染)及远期治疗效果(再出血)。结果 42例患儿均成功实施手术。两组性别、年龄、憩室长度、憩室基底/相邻肠管直径比、憩室位置、距回盲部距离、异位组织等一般资料对比,差异无统计学意义(P>0.05)。研究组切口总长度为2.70(2.40,3.53)cm、下床活动时间为0.75(0.51,1.65)d,均优于对照组的5.00(4.00,6.00)cm、2.00(1.50,2.65)d,差异有统计学意义(P<0.05);两组住院时间、手术时间、术中出血量、术后肠鸣音恢复时间、术后肛门排气时间、开始进食时间、腹部并发症、腹外并发症、切口感染及再出血情况比较,差异无统计学意义(P>0.05)。常规随访,42例患儿均无再出血发生,无腹痛、粘连性肠梗阻等情况。结论 与传统腹腔镜辅助下经脐部切口提出行憩室切除的肠吻合术相比,腹腔镜下根部缝扎法的切口短,且安全、有效,具有操作简单、创伤小、临床效果佳、易于推广等优势。Objective To analyze the safety and feasibility of laparoscopic basal ligation in the treatment of Merkel’s diverticulum(MD).Methods A total of 442 children with Merkel’s diverticulum diagnosed by surgery and pathological examination were selected and divided into a research group(20 cases) and a control group(22 cases) according to the different surgical methods.The research group underwent laparoscopic basal ligation after resection,and the control group underwent conventional laparoscopic-assisted intestinal anastomosis and diverticulectomy through umbilical incision.The clinical data of the two groups were retrospectively analyzed,and the clinical indexes of the two groups were compared,including hospitalization time,operation time,total length of incision,intraoperative blood loss,off-bed activity time,recovery time of postoperative bowel sounds,postoperative anal exhaust time,postoperative feeding time,complications(abdominal complications,extra-abdominal complications,incisional infection) and long-term treatment effect(rebleeding).Results All 42 patients successfully completed the surgery.The general data of gender,age,diverticulum length,diverticulum base/adjacent intestinal tube diameter ratio,diverticulum location,distance from the ileocecal region,and ectopic tissue were compared between the two groups,and the differences were not statistically significant(P>0.05).The research group had total incision length of 2.70(2.40,3.53) cm and off-bed activity time of 0.75(0.51,1.65) d,which were better than 5.00(4.00,6.00) cm and 2.00(1.50,2.65) d in the control group,and the differences were statistically significant(P0.05).Routine follow-up showed that 42 children had no rebleeding,abdominal pain,adhesive intestinal obstruction.Conclusion Compared with conventional transumbilical incision for diverticulectomy and intestinal anastomosis,laparoscopic basal ligation for Meckel’s diverticulectomy has a short incision and is safe and effective,with the advantages of simple operation,small trauma,good clinic

关 键 词：梅克尔憩室 儿童 腹腔镜下根部缝扎法 肠吻合术 

分 类 号：R726.5[医药卫生—儿科]