Hu Tao,Huang Guangbin,Gao Heyun,et al.Clinical application of self-inflicted ligation line during transumbilical laparoscopic single-hole appendectomy in children[J].Journal of Clinical Pediatric Surgery,2022,21(09):871-875.[doi:10.3760/cma.j.cn101785-202201023-014]
自制套扎线在儿童经脐单孔腹腔镜阑尾切除术中的应用
- Title:
- Clinical application of self-inflicted ligation line during transumbilical laparoscopic single-hole appendectomy in children
- Keywords:
- Appendicitis/SU; Laparoscopes; Sutures; Foreign-Body Reaction
- 摘要:
- 目的 评估自制套扎线在儿童经脐单孔腹腔镜阑尾切除术中的应用效果及安全性。方法 回顾性分析武汉大学中南医院小儿外科2019年5月至2021年9月共64例采用单孔腹腔镜手术治疗的阑尾炎患儿临床资料，按照不同的阑尾处理方法分为观察组和对照组，观察组采用自制SMC结或Nicky’s结套扎线结扎阑尾根部（44例），对照组采用常规器械打结处理阑尾根部（20例）。分别比较观察组和对照组患儿手术时长、打结时长、术中失血量、有无中转开腹以及术后有无出血、腹腔脓肿、阑尾残端瘘、肠管损伤及切口感染等并发症，并记录两组患儿术后随访情况。结果 所有患儿均顺利完成手术，无一例中转开腹，无再次手术病例，无术后出血、腹腔脓肿、阑尾残端漏、肠管损伤及切口感染等并发症。观察组和对照组的手术时长分别为（52.4±17.0） min和（50.6±17.3） min，打结时长分别为（5.32±0.36） min和（5.14±0.34） min，术中失血量分别为（6.4±1.7） mL和（6.5±1.3） mL，差异均无统计学意义（P>0.05）。门诊随访3~29个月，观察组与对照组均无一例切口疝、阑尾残株炎、粘连性肠梗阻或慢性窦道形成。结论 儿童经脐单孔腹腔镜阑尾切除术中，采用丝线自制SMC结或Nicky’s结圈套线处理阑尾根部安全可靠，操作简单实用，具有良好的临床应用价值。
- Abstract:
- Objective To assess the efficacy and safety of self-inflicted ligation line for transumbilical single-hole laparoscopic appendectomy in children.Methods From May 2019 to September 2021, a total of 64 cases of children with appendicitis treated with single-hole laparoscopic surgery were retrospectively analyzed, divided into observation group and control group.The observation group was homemade SMC knot or Nicky’s ligature cord ligation of the root of the appendix (44 cases), and the control group was conventional instrument knotting treatment of the root of the appendix (20 cases).The length of surgery, the length of knotting, the length of intraoperative blood loss, the presence or absence of open abdomen or switch, the absence of bleeding after surgery, the abdominal abscess, the fistula of the appendix, the injury of the intestinal tube and the incision infection were compared in the observation group and the control group, and the postoperative follow-up of the children in each group was recorded.Results All the children successfully completed the operation, none of them had a case of open abdomen, no cases of re-operation, no complications such as postoperative bleeding, abdominal abscess, appendix stump leakage, intestinal canal injury and incision infection, and were all cured and discharged from the hospital.The operative duration of the observation and the control groups was (52.4±17.0) vs.(50.6±17.3) min, the knotting duration (5.32±0.36) vs.(5.14±0.34) min, and the intraoperative blood loss (6.4±1.7) vs.(6.5±1.3) mL, and those showed no significant statistically differences(P>0.05).During an outpatient follow-up period of 3 to 29 months, there was no onset of incisional hernia, appendicitis, adhesive intestinal obstruction or chronic sinus formation.Conclusion Single-hole laparoscopy for uncomplicated appendicitis in children, using silk thread homemade SMC or Nicky’s knot tying, may manage appendiceal root safely and reliably.Operation is both simple and practical with an excellent clinical application value.
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备注/Memo
收稿日期:2022-05-23。
基金项目:武汉大学自主科研项目（2042020kf0153）
通讯作者:张文,Email:wzhang115@163.com