[1]贾金华 孔萌 刘红真 秦虹 刘传阳 张士松**.经脐单一部位腹腔镜手术治疗小儿梅克尔憩室122例[J].中国微创外科杂志,2024,01(9):599-603.
　Jia Jinhua,Kong Meng,Liu Hongzhen,et al.Transumbilical Singlesite Laparoscopic Treatment of Meckel’s Diverticulum in Children: Experience of 122 Cases[J].Chinese Journal of Minimally Invasive Surgery,2024,01(9):599-603.
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经脐单一部位腹腔镜手术治疗小儿梅克尔憩室122例()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2024年9期
页码:
599-603
栏目:
临床论著
出版日期:
2024-09-25

文章信息/Info

Title:
Transumbilical Singlesite Laparoscopic Treatment of Meckel’s Diverticulum in Children: Experience of 122 Cases
作者:
贾金华 孔萌 刘红真 秦虹 刘传阳 张士松**
(山东大学附属儿童医院济南市儿童医院普外科，济南250022)
Author(s):
Jia Jinhua;  Kong Meng;  Liu Hongzhen;  et al.
Department of General Surgery, Children’s Hospital Affiliated to Shandong University, Jinan Children’s Hospital, Jinan 250022, China
关键词:
梅克尔憩室; 经脐单一部位; 腹腔镜
Keywords:
Meckel’s diverticulum; Transumbilical singlesite; Laparoscope
文献标志码:
A
摘要:
目的探讨经脐单一部位腹腔镜手术治疗小儿梅克尔憩室(Meckel’s diverticulum，MD)的安全性和可行性。方法2019年1月～2023年6月我科采用经脐单一部位腹腔镜手术治疗MD 122例，经脐部取纵行切口，切口左右分别置入5 mm trocar，于观察孔和操作孔置入腹腔镜和无损伤肠钳，探查腹腔并寻找憩室，扩大脐部切口后将憩室提出腹腔外行切除吻合。结果122例患儿均在腹腔镜下明确诊断；4例术前诊断为急性坏疽性阑尾炎，术中腔镜探查诊断为MD合并穿孔；憩室合并下消化道出血48例、炎性反应38例、肠套叠12例、索带卡压肠梗阻8例、穿孔致腹膜炎12例。所有手术均顺利完成，手术时间58～125 min，平均78 min。术后病理均证实为MD。2例切口感染,经换药治疗后治愈。术后2～4 d开始流质饮食，5～9 d出院。119例患儿术后随访3～18 个月，手术效果满意，无术后便血、吻合口狭窄、粘连性肠梗阻、切口疝等严重并发症发生。结论经脐单一部位腹腔镜手术治疗小儿MD安全可行，MD合并穿孔或肠梗阻并不是经脐单一部位腹腔镜手术的禁忌证。
Abstract:
ObjectiveTo investigate the safety and feasibility of transumbilical singlesite laparoscopic treatment of Meckel’s diverticulum in children.MethodsA total of 122 patients with Meckel’s diverticulum were treated with transumbilical singlesite laparoscopic treatment in our department from January 2019 to June 2023. A longitudinal incision was made through the umbilical cord, and 5 mm trocars were inserted into the left and right sides of the incision. The laparoscope and noninvasive intestinal forceps were inserted via the observation and operation holes to probe the abdominal cavity and locate the diverticulum. After the umbilical cord incision was expanded, the diverticulum was pulled out from the abdominal cavity for external resection and anastomosis.ResultsAll the 122 children were diagnosed by laparoscopy. There were 4 cases who were diagnosed as having acute gangrenous appendicitis preoperatively, but were confirmed as having Meckel’s diverticulum with perforation under laparoscope intraoperatively. There were 38 cases of lower digestive tract bleeding, 48 cases of inflammatory reaction, 12 cases of intussusception, 8 cases of intestinal obstruction caused by cord and band compression, and 12 cases of peritonitis caused by perforation. All the operations were successfully completed, and the operation time was 58-125 min, with an average of 78 min. Pathological examination after surgery showed Meckel’s diverticulum in all the cases. Two cases of incision infection were cured after dressing change treatment. The patients were given a liquid diet 2-4 d after surgery and discharged 5-9 d later. A total of 119 patients were followed up for 3-18 months after surgery, and the surgical results were satisfactory. There were no serious complications such as rectal bleeding, anastomotic stenosis, adhesive intestinal obstruction, or incisional hernia after surgery.ConclusionsTransumbilical singlesite laparoscopic treatment of Meckel’s diverticulum in children is safe and feasible. Meckel’s diverticulum combined with perforation or intestinal obstruction is not a contraindication of transumbilical singlesite laparoscopic surgery.

参考文献/References:

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备注/Memo

备注/Memo:
基金项目：山东省自然科学基金面上项目（ZR2022MH229）；济南市卫生健康委员会科技计划项目（2023-1-53）；山东大学附属儿童医院2023年高层次科研计划项目（SDFE-GCC2023005）**通讯作者，Email:zsli323@163.com
更新日期/Last Update: 2024-12-17