小儿腹腔镜术中并发症的处理(附43例报告)

Laparoscopic operation complication in children:Report of 439 cases

目的：探讨腹腔镜手术在小儿泌尿外科的临床应用及其并发症的处理。方法：对2000年1月～2006年12月间的43例小儿腹腔镜手术患者进行回顾性分析。结果：43例患者涉及6种以上术式，结果8例出现术中并发症，主要发生在前期30例中，其中中转开腹手术1例，腹膜前气肿1例，皮下气肿1例，穿刺孔大网膜痛1例，膀胱损伤1例，腹内肠管损伤1例，大血管损伤2例，未出现穿刺孔感染、出血、麻醉意外等并发症。结论：小儿泌尿外科的大部分疾病可以使用腹腔镜手术治疗，但其手术适应证有待进一步探讨。小儿腹腔镜手术中转开腹手术的比例较大，熟练的常规手术经验是腹腔镜手术最重要的安全保障。

Objective：To study the clinical application and the treatment of complication in children＇s urological surgery by laparoscope. Methods： A retrospective analysis was made on clinical reports of 43 cases of children laparoscopic operations from January 2000 to December 2006. Results：43 patients were treated with more than six different kinds of surgeries, and 8 cases of complication mainly occurred on the first 30 cases of operations, which included 1 case of conversion to open surgery, 1 case of preperitoneal emphysema, 1 case of cutaneous emphysema, 1 case of gastrocolic omentum pain on the paracentesis point, 1 case of bladder injury, 1 case of scathe on intestinal canal and 2 cases of injury of blood vessel. No anesthetic accident, infection and haemorrhage on paracentesis point were occured. Conclusions：Most of pediatric urological diseases can be cured by laparoscopic operation, however, the operation indication needs further investigation. Many laparoscopic operations on children require conversion to open surgery, so the most important security insurance of laparoscopic operation is to have more ordinary operation experiences.