腹腔镜修补术在青少年十二指肠溃疡穿孔中的临床应用

Laparoscopic repair for juveniles with duodenal ulcer perforation

目的探讨腹腔镜手术在青少年十二指肠穿孔中的应用价值。方法2003年7月至2008年7月，非随机将21例十二指肠穿孔患儿分为腹腔镜手术组和传统开腹组，对比观察手术操作情况及患儿术中、术后情况，结果通过统计学分析。结果所有手术均顺利完成，腹腔镜手术修补青少年十二指肠穿孔均获成功无中转开腹，手术时间（75．5±18．0）min，较开腹手术（68．5±14．7）min无明显延长，住院时间腹腔镜组（5．8±1．8）d，对比开腹组（6．5±1．5）d亦无明显差别。术后无严重并发症发生。随访3～18个月，无远期并发征发生。结论在青少年十二指肠穿孔患者中，腹腔镜手术可以替代传统开腹手术。

Objective To evaluate the application of laparoscopic surgery for juveniles with duodenal ulcer perforation. Methods From July 2003 to July 2008, clinical data from 21 juveniles with duodenal ulcer perforation in this hospital were analyzed retrospectively. Twenty-one patients with the clinical diagnosis of duodenal ulcer perforation were allocated into two groups to undergo either open or laparoscopic surgery. The mean operating time, mean length of stay and the incidence of postoperative complications in both groups were compared. Results Both of the procedures were performed successfully for all patients. None in the laparoscopic group required conversion to an open procedure. No significant difference was noted in the mean operating time between the laparoscopic and open surgery group （75.5 ± 18.0 min vs 68. 5± 14. 7 min, P= 0. 37） or in the mean length of stay （5.8 ± 1.8 d vs 6. 3 ± 1.5 d）. No severe complication was noted in either group. Conclusions Laparoscopic repair is technically feasible and safe, which is an effective alternative for juveniles with duodenal ulcer perforation.