经脐单孔腹腔镜手术治疗儿童肠套叠的临床分析

Clinical Analysis of Umbilical Single-port Laparoscopic Surgery for Intussusception in Children

目的总结经脐单孔腹腔镜手术治疗儿童复发肠套叠的临床手术经验。方法回顾性分析大连医科大学附属儿童医院普外科2010年1月至2019年1月收治的经脐单孔腹腔镜手术治疗儿童肠套叠50例的临床资料。经脐切口,放置10mmTrocar,置入带5mm操作通道的0°腹腔镜,用无损伤钳反复牵拉套入肠管使之复位。结果50例病例中,35例为原发性肠套叠复发,在腹腔镜下行肠套叠复位术;继发性肠套叠15例,其中美克尔憩室10例,盲肠息肉1例,回肠息肉2例,经脐扩大切口完成梅克尔憩室切除、息肉切除、肠切除肠吻合术;2例为肠套叠合并过敏性紫癜,术后转入内科继续治疗。50例病例术后随访1个月~2年,其中有1例再次出现肠套叠,转入北京医院治疗,余病例术后无复发,无肠瘘及术后肠梗阻等并发症。结论经脐单孔腹腔镜治疗儿童复发性肠套叠安全可靠,术后无瘢痕、创伤小,符合人们对美的追求,值得临床推广。

Objective To summarize the clinical experience of transumbilical single-port laparoscopic surgery for children with recurrent intussusception. Methods Retrospective analysis of the clinical data of 50 cases of children's intussusception treated by transumbilical single-port laparoscopic surgery from January 2010 to January 2019 in Dalian Children's Hospital of Dalian Medical University. Through the umbilical incision, place a 10mmTrocar, place a 0° laparoscope with a 5 mm operation channel, and repeatedly pull the intestine into the intestine with a non-invasive forceps to reset it. Resutls In these 50 cases,35 cases were diagnosed as recurrent intussusception, and laparoscopic intussusception were performed.15 cases were diagnosed as secondary intussusception, there were 10 cases of Meckel's diverticulum, 1 case of cecal polyps, and 2 cases of ileal polyps. The umbilical dilatation was performed to complete the Merkel diverticulectomy, polypectomy, intestinal resection and intestinal anastomosis. 2 cases were diagnosed as intussusception combined with allergic purpura. After surgery, they were transferred to internal medicine for further treatment.50 patients were followed up for 1 month to 2 years. One of them had an intussusception recurrence and transferred to Beijing Hospital. There were no recurrences in the remaining cases, no complications such as intestinal fistula and postoperative intestinal obstruction. Coclusions The umbilical single-port laparoscopy is safe and reliable for children with recurrent intussusception.There is no scar and less trauma after operation, which is in line with people's pursuit of beauty and worthy of clinical promotion.