He Yuanfei,Qi Shiqin,Wei Decheng,et al.Curative efficacy of single-port laparoscopic suspension for resecting intestinal duplication deformity[J].Journal of Clinical Pediatric Surgery,2026,(06):567-571.[doi:10.3760/cma.j.cn101785-202412045]
单孔腹腔镜悬吊法切除小肠重复畸形的疗效观察
- Title:
- Curative efficacy of single-port laparoscopic suspension for resecting intestinal duplication deformity
- Keywords:
- Intestine; Small; Duplication of Intestine; Laparoscopes; Digestive System Surgical Procedures; Treatment Outcome
- 摘要:
- 目的 探讨单孔腹腔镜悬吊法切除小肠重复畸形的可行性及临床疗效。方法 本研究为回顾性队列研究。收集2021年1月至2024年12月安徽省儿童医院普外科采取单孔腹腔镜悬吊法与腹腔镜辅助拖出法行小肠重复畸形切除术的33例患儿临床资料。根据不同术式分为单孔腹腔镜悬吊法组(n＝21)和腹腔镜辅助拖出法组(n＝12),比较两组手术时间、术中出血量、术后进食时间、术后住院天数及术后并发症等。结果 33例均顺利完成手术,单孔腹腔镜悬吊法组均在腹腔内完整剥离囊肿并与肠吻合;腹腔镜辅助拖出法组均将肠管拖出体外行囊肿剥除并与肠吻合。单孔腹腔镜悬吊法组手术时长为64.00(61.00,65.00)min,腹腔镜辅助拖出法组手术时长为62.00(56.25,74.50)min,差异无统计学意义(Z＝-0.019,P＝0.985)。单孔腹腔镜悬吊法组术中出血量为5.30(5.00,5.40)mL,腹腔镜辅助拖出法组术中出血量为10.00(10.00,10.75)mL,差异具有统计学意义(Z＝-4.115,P<0.001);单孔腹腔镜悬吊法组术后进食时间为3.00(3.00,3.00)d,腹腔镜辅助拖出法组术后进食时间为5.00(4.25,5.00)d,差异具有统计学意义(P<0.001);术后住院时间比较,单孔腹腔镜悬吊法组为5.00(4.00,6.00)d,腹腔镜辅助拖出法组为7.00(6.25,7.00)d,差异亦具有统计学意义(P<0.001)。单孔腹腔镜悬吊法组无一例出现术后并发症,腹腔镜辅助拖出法组术后出现3例并发症,其中2例切口感染、1例不完全性肠梗阻,差异具有统计学意义(P<0.05)。两组引流管留置率差异无统计学意义(P＞0.05)。单孔腹腔镜悬吊法组术后仅留脐部下缘疤痕,美观度好。两组随访3个月均无一例复发。结论 单孔腹腔镜悬吊法切除小肠重复畸形安全、有效,较腹腔镜辅助拖出法创伤小、并发症少、恢复快。
- Abstract:
- Objective To evaluate the feasibility and clinical efficacy of single-port laparoscopic suspension in resecting small intestinal duplication in children. Methods For this retrospective cohort study,the relevant clinical data were collected from 33 children undergoing resection of small intestinal duplication between January 2021 and December 2024.Based upon specific surgical approaches,they were assigned into two groups of single-port laparoscopic suspension (n=21) and laparoscopic-assisted exteriorization (n=12).Operative duration,intraoperative volume of blood loss,time to postoperative feeding,length of hospitalization stay and postoperative complications were compared for assessing the advantages and disadvantages of two approaches. Results All procedures were successfully completed.In single-port group,complete intracorporeal cyst resection and intestinal anastomosis were achieved.In laparoscopic-assisted group,bowel loops were exteriorized for cyst removal and anastomosis.The median operative duration was 64.00(61.00,65.00) min in single-port group and 62.00(56.25,74.50) min in laparoscopic-assisted group.There was no statistically significant difference (Z=-0.019,P=0.985).Intraoperative volume of blood loss was significantly lower in single-port group than that in laparoscopic-assisted group[5.30(5.00,5.40) vs. 10.00(10.00,10.75) mL](Z=-4.115,P<0.001).Time to postoperative oral intake was significantly shorter in single-port group than that in laparoscopic-assisted group[3.00(3.00,3.00) vs. 5.00(4.25,5.00) day](Z=-4.787,P<0.001).Postoperative hospitalization stay was significantly shorter in single-port group than that in laparoscopic-assisted group[5.00(4.00,6.00) vs. 7.5(6.0,10.0) day](Z=-4.510,P<0.001).Postoperative complications occurred in 3 cases in laparoscopic-assisted group (2 incision infections,1 suspected partial intestinal obstruction) while no complications occurred in single-port group.There was statistically significant difference (P=0.040).Drain placement rate was 14.3%(3/21) in single-port group and 16.7%(2/12) in laparoscopic-assisted group.There was no statistically significant difference (P=1.000).No cases of postoperative hemorrhage,incision infection,intestinal perforation or obstruction occurred in single-port group.Furthermore,only small scar beneath umbilicus was left,offering excellent cosmetics.No recurrence of intestinal duplication was noted in neither groups during 3-month follow-ups. Conclusion Single-port laparoscopic suspension resection for small intestinal duplication is a safe,effective and feasible surgical technique,offering minimal invasiveness,fewer complications and rapid recovery.
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备注/Memo
收稿日期:2024-12-17。
通讯作者:戚士芹,Email:qishiqin@163.com