小儿腹腔及腹膜后囊性肿物腹腔镜治疗11例

Laparoscopic treatment of abdominal and retroperitoneal cystic masses in 11 children

目的探讨腹腔镜治疗小儿腹腔及腹膜后囊性肿物的可行性及疗效。方法回顾性分析2015年6月至2019年1月福建医科大学附属泉州第一医院小儿外科收治的腹腔或腹膜后囊性肿物患儿11例,其中男6例,女5例;年龄8个月~10岁,平均59个月。患儿囊性肿物9例来源于腹腔,2例来源于腹膜后,均于腹腔镜下行肿物切除术。结果11例患儿均于腹腔镜下完成手术,术中均无中转开腹。手术时间60~210 min,平均120 min;术中出血量5~30 mL,平均10 mL;术中均无患儿输血。术后住院时间3~8 d,平均5 d。11例患儿术后病理提示:成熟性畸胎瘤5例,副中肾管囊肿1例,回肠重复畸形2例,淋巴管瘤2例,肝囊肿1例。11例患儿术后随访7~51个月,平均20.9个月,无患儿病情复发。结论腹腔镜治疗小儿腹腔及腹膜后囊性肿物创伤小、恢复快,安全可行,疗效确切。

Objective To explore the feasibility and efficacy of laparoscopic resection of abdominal and retroperitoneal cystic masses in children.Methods A retrospective analysis of 11 cases of abdominal and retroperitoneal cystic masses in Department of Pediatric Surgery,Quanzhou First Hospital Affiliated to Fujian Medical University from June 2015 to January 2019 was performed,and all the patients underwent laparoscopic resection or laparoscopic-assisted resection,with 6 cases of boys and 5 cases of girls,aged 8 months to 10 years(with the average of 59 months).Meanwhile,9 cases were from the abdominal cavity and 2 cases were from the retroperitoneum.Results All patients underwent laparoscopic or laparoscopic-assisted resection without switching to laparotomy.The operation time was 60-210 minutes,with the average of 120 minutes.The intraoperative blood loss was 5-30 mL,with the average of 10 mL.There was no blood transfusion.All patients were discharged 3-8 days after surgery,with the average of 5 days.The postoperative pathological results included 5 cases of mature teratoma,1 case of paraneoplastic cyst,2 cases of intestinal duplication,2 cases of lymphangioma,and 1 case of hepatic cyst.Totally,11 cases were followed up for 7-51 months,with the average of 20.9 months.No recurrence occurred.Conclusions Laparoscopic or laparoscopic-assisted resection of abdominal and retroperitoneal cystic masses has advantages of minimal invasion,rapid recovery in children,and it is safe and effective.