儿童肠系膜囊肿21例诊疗分析

Diagnosis and Treatment of Mesenteric Cyst in Children

目的总结儿童肠系膜囊肿的诊断及手术治疗选择。方法回顾2011年1月—2015年12月间收治的21例肠系膜囊肿病例的临床资料,分析诊断要点和治疗选择,比较腹腔镜手术与开腹手术的疾病预后。结果临床症状以腹部包块、腹痛、腹胀为主,术前经腹部超声和CT诊断为肠系膜囊肿。21例中传统开腹手术14例,腹腔镜手术7例,有1例中转开腹。因急腹症而急诊手术2例,开腹手术和腹腔镜手术各占1例。单纯囊肿切除14例,其中2例在肠系膜根部有少量残留;囊肿与相邻肠管一并切除7例。开腹手术平均住院天数12.00 d,腹腔镜手术平均住院天数10.14 d,无统计学差异。所有手术患者均痊愈出院,无术后并发症,随访无复发。结论肠系膜囊肿的手术方式要根据囊肿与相邻肠管或器官的关系而定,总体治疗效果良好。选择性地应用腹腔镜手术将会使更多患儿受益。

Objective To summarize the diagnosis and surgical treatment of mesenteric cyst in children. Methods The clinical records of mesenteric cyst cases from January 2011 to December 2015 were reviewed retrospectively. The diagno-sis and treatment options were analyzed, and the prognosis of laparoscopic surgery and laparotomy was compared. Results The main clinical symptoms included abdominal mass, abdominal pain, and abdominal distension. Abdominal ultrasound and/or CT scan were the diagnostic tools in all cases. Traditional laparotomy was performed in 14 cases , while laparoscopy in 7 cases （1 case switched to laparotomy）. 2 cases had emergency surgery due to acute abdomen, laparotomy and laparoscopy in each case. Simple cyst resections were completed in 14 cases, of which 2 cases with a small amount of residual in the mes-enteric root. Intestinal resection and anastomosis were required in other 7 cases. The average time of hospital stay for laparot-omy group was 12 days, and 10. 14 days for laparoscopy group. There was no significant difference. All patients were dis-charged without postoperative complications. With 1 -4 years follow - up, there was no recurrence. Conclusion The opera-tion for mesenteric cysts depends on the relationship between the cyst and the adjacent bowel or organs, and the overall out-come is favorable. The selective use of laparoscopy will benefit more children.