[1]卢朝祥 王琪*.腹腔镜与开腹Ladd手术治疗新生儿肠旋转不良的比较[J].中国微创外科杂志,2019,01(9):821-825.
　Lu Chaoxiang,Wang Qi..Comparative Study Between Laparoscopic and Open Ladd’s Procedure for the Treatment of Congenital Intestinal Malrotation in Neonates[J].Chinese Journal of Minimally Invasive Surgery,2019,01(9):821-825.
点击复制

腹腔镜与开腹Ladd手术治疗新生儿肠旋转不良的比较()
分享到：

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2019年9期
页码:
821-825
栏目:
临床研究
出版日期:
2019-09-25

文章信息/Info

Title:
Comparative Study Between Laparoscopic and Open Ladd’s Procedure for the Treatment of Congenital Intestinal Malrotation in Neonates
作者:
卢朝祥 王琪*
（陕西省西安市儿童医院新生儿外科，西安710003）
Author(s):
Lu Chaoxiang;  Wang Qi.
Department of Neonatal Surgery, Xi’an Children’s Hospital, Xi’an 710003, China
关键词:
腹腔镜; Ladd手术; 肠旋转不良; 新生儿
Keywords:
Laparoscopy; Ladd’s procedure; Intestinal malrotation; Neonate
文献标志码:
A
摘要:
目的比较腹腔镜与开腹Ladd手术治疗新生儿肠旋转不良(排除肠坏死)的效果。方法我院2013年1月~2017年5月对74例新生儿肠旋转不良但不伴肠坏死行开腹（49例）或腹腔镜镜Ladd手术（25例），比较2组患儿手术时间、住院时间、术后并发症等情况。结果腹腔镜组手术时间中位数118、0（86.5，137.5）min，明显长于开腹组63.0（55.0，705）min（Z=-5.328，P=0.001）；住院时间中位数13.0（11.6，16.0）d，与开腹组14.0（10.5，21.0）d无统计学差异（Z=-0.791，P=0.729）。2组术后粘连性肠梗阻（χ2=0.034，P=0.853）、再扭转（Fisher精确检验，P=1.000）、切口感染（Fisher精确检验，P=1.000）、漏诊（Fisher精确检验，P=0.338）发生率无统计学差异。结论腹腔镜下Ladd手术治疗于新生儿肠旋转不良，不增加术后并发症，同时具有恢复快，美观等优点，可以在腹腔镜下将肠管顺利复位，使手术顺利完成。
Abstract:
ObjectiveTo compare the effect between laparoscopic and open Ladd’s procedure for the treatment of neonatal intestinal malrotation (excluding intestinal necrosis). MethodsFrom January 2013 to May 2017, a total of 74 children who were diagnosed as having neonatal intestinal mrotation without intestinal necrosis were treated in our hospital. They were divided into either open group(n=49) or laparoscopic group(n=45).The operation time, hospital stay, and postoperative complications were compared between the two groups.ResultsThe median operative time was 118.0 (86.5, 137.5) min in the laparoscopic group, which was significantly longer than that in the open group ［63.0 (55.0, 70.5) min, Z=-5.328, P=0.001］. The median hospital stay was 13.0 (11.6, 16.0) d in the laparoscopic group and 14.0 (10.5, 21.0) d in the open group, without significant difference (Z=-0.791, P=0.729). There were no differences between the two groups in postoperative adhesion intestinal obstruction (χ2=0.034, P=0.853), retorsion (Fisher’s exact test, P=1000), incision infection (Fisher’s exact test, P=1.000), and missed diagnosis (Fisher’s exact test, P=0.338).ConclusionsLaparoscopic Ladd’s procedure can be safely used for intestinal malrotation in the neonatal period. It does not increase the complications after operation, and has the advantages of quick recovery and beautiful appearance. It can successfully reposition the intestinal tube under laparoscopy and make the operation complete smoothly.

参考文献/References:

[1]任红霞,吴晓霞.腹腔镜治疗新生儿肠旋转不良、肠扭转.临床外科杂志,2017,25(12):888-889.
[2]Agrawal V, Tiwari A, Acharya H, et al. Laparoscopic ‘steering wheel’ derotation technique for midgut volvulus in children with intestinal malrotation.J Minim Access Surg,2018,3(15):219-223.
[3]Wu MH, Hsu WM, Lin WH, et al. Laparoscopic Ladd’s procedure for intestinal malrotation: report of three cases. J Formos Med Assoc,2002,101(2):152-155.
[4]王婧,苏泽礼,冯启立,等.先天性肠旋转不良的临床研究.宁夏医学杂志,2017,39(6):551-552.
[5]周崇高,李碧香,王海阳,等.新生儿肠旋转不良并中肠扭转的微创手术治疗.临床小儿外科杂志,2016,15(2):167-169.
[6]许光，周崇高，夏仁鹏，等.腹腔镜与开腹手术治疗新生儿先天性肠旋转不良的比较研究.中国微创外科杂志,2017,17(11):978-981.
[7]李恩就，龚志军，卿笃桔，等.不同手术方法治疗肠旋转不良的疗效及对免疫功能的影响探讨.数理医药学杂志,2017,30(3):347-348.
[8]杨纪亮，李乐，潘静，等.开腹和腹腔镜手术治疗小儿肠旋转不良的临床对比研究.岭南现代临床外科,2015,15(6):674-677.
[9]闫学强，郑楠楠，卞红强，等.腹腔镜Ladd手术治疗婴幼儿先天性肠旋转不良.中华消化外科杂志,2015,14(10):848-851.
[10]Catania VD, Lauriti G, Pierro A, et al. Open versus laparoscopic approach for intestinal malrotation in infants and children: a systematic review and metaanalysis. Pediatr Surg Int,2016,32(12):1157-1164.

备注/Memo

备注/Memo:
*通讯作者，Email：13468827066@163.com
更新日期/Last Update: 2019-12-10