目的 探讨直线切割闭合器在小儿消化道手术中应用的有效性、安全性及可行性。 方法 2012年5月至2016年7月间本院使用直线切割闭合器实施消化道手术共332例,其中251例胆道闭锁和胆总管囊肿患儿行三角吻合术(胆道闭锁217例,胆总管囊肿34例),52例行肠造瘘术,21例各种血液病伴脾肿大患儿行脾切除术,1例脾脓肿行脾及胰尾切除术,4例回肠美克尔憩室行憩室切除术,2例幽门瘢痕狭窄行胃空肠吻合术,1例食管下端狭窄行狭窄段切除+食管胃吻合术。332例中,实施腹腔镜手术114例,传统开放手术218例。 结果 除初期使用切割闭合器实施胆道闭锁手术的患儿发生吻合口瘘2例,吻合口狭窄1例,早期粘连性肠梗阻1例以外,其余患儿随访1个月至4年,无一例闭合器相关并发症发生。 结论 使用切割闭合器进行儿童消化道手术简便,安全,有效,值得临床推广应用。
Objective To explore the clinical efficacy, feasibility and safety of a linear cutting closer for pediatric gastrointestinal surgery. Methods From May 2012 to July 2016, 332 hospitalized patients underwent surgery by a linear cutting closer, including 251 cases of triangle anastomosis(biliary atresia,n=217; common bile duct cyst, n=34). Among 52 cases of intestinal colostomy, there were splenectomy for hematonosis with splenomegaly(n=21), spleen and pancreatic tail resection for splenic abscess(n=1), Meckel's diverticulum resection of ileum(n=4), gastrojejunostomy for pylorus cicatricial stenosis(n=2)and esophagogastrostomy for lower esophageal stricture(n=1). And laparoscopy(n=114)and traditional open surgery(n=218)were performed. Results During a follow-up period of 1 month to 4 years, closer-related complications included anastomotic leakage(n=2), anastomotic stricture(n=1)and early adhesive intestinal obstruction for biliary atresia(n=1). Conclusion Using cutting closer is simple, safe and effective for pediatric gastrointestinal surgery so that it is worthy of clinical popularization.
