小儿腹腔镜阑尾切除术中阑尾系膜的处理方法及并发症原因分析

Analysis of the treatment method of the mesoappendix and causes of complications in pediatric laparoscopic appendectomy

目的:探讨小儿腹腔镜阑尾切除术中肠系膜的处理方法及对患儿预后的影响。方法:回顾分析65例腹腔镜阑尾切除术患儿的临床资料,术中采用单纯丝线结扎法、电凝法及超声刀法处理阑尾系膜。结果:65例患儿均痊愈出院,其中24例采用单纯丝线结扎法处理阑尾系膜,术后无并发症发生;28例采用电凝法,术后6例出现回盲部周围积液、1例回盲部肠瘘;13例采用超声刀凝切处理,术后3例出现回盲部周围积液。术后住院5~13 d,随访1~6个月,均无其他并发症发生。结论:小儿腹腔镜阑尾切除术中采用单纯丝线结扎阑尾系膜可有效减少术后并发症的发生。

Objective： To investigate treatment method of the mesoappendix and its effect on the prognosis of pediatric laparoscopic appendectomy. Methods： The clinical data of 65 children who underwent laparoscopic appendectomy were retrospectively analyzed. Mesoappendix was treated in different methods： pure silk ligation method,electrocoagulation and ultrasonic knife. Results： All of65 patients were cured,including 24 cases by pure silk ligation method（ no postoperative complications）,28 cases by electrocoagulation（ 6 cases of the ileocecal effusion,1 case of ileocecal fistula after operation）,13 cases by ultrasonic knife method（ ileocecal region effusion occurred in 3 cases after operation）. Postoperative hospital stay was 5-13 d and children were followed up for 1-6 months,no other complications were found. Conclusions： The pure silk ligation of the mesoappendix in pediatric laparoscopic appendectomy could effectively reduce the postoperative complications.