二孔法儿童微型腹腔镜阑尾切除术

Mini-laparoscopic Appendectomy by Two-hole Methodin Children

目的探讨二孔法儿童微型腹腔镜阑尾切除术MLA的可行性及优越性。方法本组对31例急性阑尾炎患儿行二孔法MLA。术中在脐部和右下腹二孔置入微型腹腔镜器械,将阑尾自5.5mmTrocar孔拖出,体外结扎系膜,切除阑尾,再将阑尾残端回纳腹腔,腹腔镜观察腹腔无异常后,切口对合粘贴。结果本组31例患儿手术时间25～35min熏平均30min熏术后8～12h患儿开始饮水,10～12h即可下床活动,术后3～5d均痊愈出院。无切口及腹内并发症。结论二孔法儿童微型腹腔镜阑尾切除术方法简便,比三孔法腹腔镜阑尾切除术LA更简单、经济,并发症少,手术时间短,切口更小,瘢痕更小,美容效果更好,适用于儿童急性单纯性阑尾炎。

Objective To explore the availability and advantage of two-hole method with mini-laparoscopic appendectomy in children. Methods 31 cases with acute appendicitis were treated by two-hole method with mini-laparoscopic appendectomy(MLA).A clamp was put into abdominal cavity through a hole (5.5mm trocar)in the right-low abdomen ,while the laparoscope through another(3.5mm trocar) in the umbilical foramen. The appendix was take out from abdominal cavity and the appendiceal mesentery was ligated and cut off. After the appendix was resected off, the appendiceal stump was put back into the abdominal cavity. The incisions were sutured after watching the abdominal cavity. Results The operating time ranged from 25 to 35 minutes(average 30 minutes). The patients begun to drink some water and to walk about 10 to 12 hours after the operation. There were no complication of incision and abdominal cavity among all cases. The time in hospital stay were 3 to 5 days. Conclusions Two-hole method MLA is high security, shorter operating time,lower cost,small incision and scar,less complication and could obtain all the more cosmetic efficacy.