腹腔镜在小儿外科疾病中的应用

The application of laparoscopy in pedialric surgery

目的:总结应用腹腔镜技术开展小儿外科手术的经验。方法:腹腔镜手术52例,其中经后腹腔入路离断性肾盂成形术3例,肾囊肿去顶术1例,经腹腔入路行小儿腹股沟斜疝及小儿交通性鞘膜积液内环口结扎术35例,阑尾切除术6例、肾母细胞瘤破裂止血活检术1例,隐睾探查松解下降固定术6例。结果:除1例因隐睾位于近肾下极处腹腔镜手术困难中转开放手术外,其余手术均获成功。住院时间1～7d,随访1.5个月～2年,无并发症发生,疝及鞘膜积液无复发。结论:腹腔镜手术治疗小儿腹股沟斜疝、小儿交通性鞘膜积液、不能触及的隐睾、肾盂输尿管连接部狭窄等疾病时,手术效果与传统手术相同,且手术时间短,术中出血量少,切口微小,术后患儿康复快,值得临床推广。

Objective ：To summarize the experience of laparoscopy in pediatric surgery. Methods：Fifty two cases were performed laparoscopic operation. The laparoscopic operative types were as follows ： breaking pyeloplasty was performed through retroperitoneal cavity in 3 cases, unroofing of cyst of kidney in 1 case, ligating the orifice of inner ring through abdominal cavity for oblique inguinal hernia and communicating hydroeele of children in 35 cases, nephroblastoma rupture hemostasis and biopsy in 1 case,cryptorehidism exploration and fixation in 6 cases. Results：All cases of laparoscopie surgery were successful except one case,which the cryptorehidism was located in inferior pole of kidney, was diffcult for laparoscopic treatment and forced to conversion. Conclusions：The laparoscopic operation can treat the children indirect inguinal hernia, children communicating hydrocele, enorchia and ureteropelvic junction stenosis. Its clinical effect is identical with traditional surgery. The advantage of laparoscopic operation is the shorter operative time,less bleed- ing, smaller incision and recovery quickly. It is worth clinical promotion.