经脐单通道腹腔镜技术在治疗小儿急性阑尾炎及梅克尔憩室中的应用研究

Clinical application of single-port intraumbilical laparoscopic surgery in appendicitis and Meckel's diverticulum

目的探讨经脐单通道腹腔镜技术在小儿急性阑尾炎及梅克尔憩室中的应用。方法 2010年6月~2011年12月采用单通道腹腔镜手术治疗小儿阑尾炎272例,梅克尔憩室48例作为临床实验组,将2008年12月~2010年5月传统开腹手术的同种病例作为对照组,分别就手术时间、住院天数、住院费用、术后并发症等指标进行比较。结果经脐单通道腹腔镜阑尾切除术的平均手术时间与常规开腹比较差异有显著性,t=-2.104,P=0.041〈0.05,住院天数与常规开腹比较差异有显著性,t=-2.142,P=0.037〈0.05,住院费用与常规开腹比较无显著差异,t=-0.819,P=0.417〉0.05。单通道与传统开腹梅克尔憩室切除术比较手术时间差异有显著性,t=-2.604,P=0.012〈0.05,住院天数差异有显著性,t=-2.6687,P=0.01〈0.05,两种术式梅克尔憩室患儿治疗费用比较差异无显著性,t=1.450,P=0.153。单通道手术的术后并发症明显减少。结论采用经脐单通道腹腔镜行阑尾切除及梅克憩室切除具有手术时间短、住院天数短、术后并发症少、美观等优点。

【Objective】To study the clinical application of single port intraumbilical laparoscopic surgery of appendicitis and Meckel＇s diverticulum in children. 【Methods】272 cases of appendicitis and 48 cases of Meckels diverticulum were treated by single port intraumbilical laparoscopic surgery from 2010 to December 2011, compared with traditional surgical method in operation time,in-patient time,hospitalization costs and surgical complications.【Results】 There were significant difference between the single port laparoscopic intraumbilical surgery and traditional surgical method in average operation time and in-patient time（t=-2.104, P =0.0410.05） in appendicitis,and so did in meckels diverticulum（average operation time： t=-2.604, P 0.05; in-patient time： t=-2.6687, P 0.05）.But there were no significant difference in hospitalization costs（Appendicitis： t =-0.819, P 0.05; Meckels diverticulum： t =1.450, P 0.05）. And the single port laparoscopic surgery makes less surgical complications.【Conclusion】Single port laparoscopic surgery of appendicitis and Meckel＇s diverticulum in children worth to be widely used with short operation time and in-patient time,less surgical complications and so on.