脐部单孔法腹腔镜小儿阑尾切除术

Umbilical one trocar laparoscopic appendectomy(UOTLA) in 52 children

目的 探讨脐部单孔法腹腔镜小儿阑尾切除术的可行性及治疗经验。方法 对 5 2例小儿急性阑尾炎采用脐部单孔法腹腔镜阑尾切除术。作脐部 1.0cm切口 ,插入外径 10mm带有 5mm操作孔的腹腔镜 ,腹腔镜下找到阑尾 ,夹住阑尾尖端 ,将阑尾完整地从脐部拖出腹腔外 ,用常规开腹阑尾切除的方法处理阑尾及其系膜 ,完成阑尾切除术。结果 本组手术时间 10～ 4 0min ,平均 (2 0 .6±6 .5 5 )min ,术后排气时间 4～ 2 7h ,平均 (14± 5 .4 5 )h。术后切口全部Ⅰ期愈合 ,无近期并发症。腹部未见切口瘢痕。结论 脐部单孔法腹腔镜阑尾切除术是小儿阑尾炎治疗中简洁、有效的手术方法之一 。

Objective To explore the feasibility of umbilical one trocar laparoscopic appendectomy (UOTLA) in children. Methods Fifty two patients with acute appendicitis underwent UOTLA. A 1?cm long incision was made through the umbilicus with a scalpel. A 10?mm laparoscope with a 5?mm operating channel was introduced into the abdominal cavity. The appendix was identified and exteriorized through the umbilical cannula. Appendectomy was performed using the traditional method, but outside the abdominal cavity. Results The mean operating time was 20.6 ± 6.55?min (range: 10～ 40?min ) in this series. The average time to resume the fluid and diet intake was 14± 5.45?hrs (range: 4～ 27?hrs ). All the incisions were healed by first intention. No recent postoperative complication occurred. From an aesthetic point of view, the transumbilical incision was practically invisible. Conclusions Our study shows that UOTLA is safe and feasible technique for the treatment of acute uncomplicated appendicitis in children. Cosmetically, it is more superior to the open surgery.