Zhou Xiaobing,Li Bingxin,Chen Aijun,et al.Role of three dimensional laparoscopy in the treatment of pediatric appendicural abscess[J].Journal of Clinical Pediatric Surgery,2020,19(05):437-440.[doi:10.3969/j.issn.1671-6353.2020.05.012]
3D腹腔镜手术治疗小儿阑尾周围脓肿
- Title:
- Role of three dimensional laparoscopy in the treatment of pediatric appendicural abscess
- Keywords:
- Appendix/SU; Abscess; Laparoscopy; Child
- 分类号:
- R726.1;R574.61
- 摘要:
- 目的 总结3D腹腔镜手术治疗小儿阑尾周围脓肿的临床经验。方法 回顾性分析三峡大学第一临床医学院普外科2013年1月至2016年8月26例行3D腹腔镜手术治疗的小儿阑尾周围脓肿病例资料，均采用三孔法腹腔镜手术，局部分离脓腔并清除脓液，分离粘连后找到阑尾，超声刀离断阑尾系膜，双重结扎或夹闭阑尾根部，切除阑尾，经操作孔取出，右侧盆腔留置引流管。结果 26例均完成3D腹腔镜下阑尾切除术，无一例中转开腹手术。术中出血量（15.5±3.1）mL，手术时间（45.6±7.8）min，术后住院时间（7.8±1.6）d。操作孔感染1例，腹腔脓肿2例，炎性肠梗阻1例，均经保守治疗痊愈。出院后随访2~24个月，中位随访时间14个月，无一例出现粘连性肠梗阻、营养不良等远期并发症。结论 3D腹腔镜手术治疗小儿阑尾周围脓肿术中操作过程的立体感更强，操作更精细，整体安全可行。
- Abstract:
- Objective To explore the clinical experience of three-dimensional (3D) laparoscopy in treatment of pediatric appendicural abscess.Methods A total of 26 cases of pediatric appendicural abscess underwent laparoscopy from January 2013 to August 2016.Three-Trocar technique was employed.Pus cavity was isolated and appendix located.Ultrasonic knife was used for dissecting appendiceal mesangium.After double ligating,appendiceal root was removed and a drainage tube implanted into right pelvis after local washing.Results Laparoscopic appendectomy was performed successfully in all 26 cases.No open laparotomy was required.The intraoperative blood loss was (15.5±3.1) ml; The operative duration (45.6±7.8) min; The postoperative hospitalization (7.8±1.6) days.There were mild incision infection (n=1),peritoneal inflammatory mass (n=2) and intestinal obstruction (n=1).All complications were cured by non-operative measures.During a median follow-up period of 14(2-24) months,there was no occurrence of such complications as adhesive intestinal obstruction or malnutrition.Conclusion For pediatric appendicural abscess,3D laparoscopy is much safer by offering a more distinct visual field and a greater spatial sense.
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备注/Memo
收稿日期:2018-08-27。
通讯作者:郭兆坤,Email:Guozhaokun0824@163.com