腹腔镜辅助手术与开腹手术治疗儿童消化道磁性异物的效果比较

Effect comparison of laparoscopic-assisted surgery and open laparotomy in the treatment of magnetic foreign body in children’s digestive tract

目的比较腹腔镜辅助手术与开腹手术治疗儿童消化道磁性异物的效果。方法选取2015年12月至2022年1月首都医科大学附属北京儿童医院收治并进行手术治疗的消化道磁性异物患儿84例。依据手术方式不同,将患儿分为开腹组(42例)、腹腔镜组(30例),余12例腹腔镜中转开腹的患儿未被纳入分组。比较两组磁性异物数量、磁性异物分布位置、磁性异物所致并发症情况、手术时间、术中出血量、术后进食时间、术后住院时间、术后并发症情况。结果两组消化道磁性异物分布在空回肠的例数比较,差异有统计学意义(P<0.05)。两组术前肠梗阻发生率、异物导致消化道穿孔发生率、消化道穿孔数量、内疝发生率比较,差异无统计学意义(P>0.05)。两组手术时间比较,差异有统计学意义(P<0.05);两组术中出血量、术后进食时间、术后住院时间比较,差异无统计学意义(P>0.05)。两组术后并发症总发生率比较,差异无统计学意义(P>0.05)。两组住院费用比较,差异有统计学意义(P<0.05)。结论腹腔镜辅助手术在小儿消化道磁性异物的治疗上与开腹手术疗效相当,术者需根据具体情况选择相应的手术方式。

Objective To compare the effect of laparoscopic-assisted surgery and open laparotomy in the treatment magnetic foreign body in children’s digestive tract.Methods From December 2015 to January 2022,84 patients with magnetic foreign bodies in digestive tract undergoing surgical treatment admitted Beijing Children’s Hospital,Capital Medical University were selected,and they were divided into open laparotomy group(42 cases),laparoscopic group(30 cases)according to the surgical method,and the remaining twelve child patients who were converted from laparoscopy to laparotomy were not included in the group.The number of magnetic foreign bodies,distribution of the magnetic foreign bodies,complications caused by magnetic foreign bodies,operation time,intraoperative blood loss,postoperative feeding time,postoperative hospitalization time,and postoperative complications were compared between two groups.Results There was statistical significance in the number of magnetic foreign bodies in empty ileum between two groups(P<0.05).There were no significant differences in the incidence of preoperative intestinal obstruction,the incidence of digestive tract perforation caused by magnetic foreign bodies,the number of digestive tract perforation,and the incidence of internal hernia between two groups(P>0.05).The operation time between two groups was statistically significant(P<0.05);there were no significant differences in intraoperative blood loss,postoperative feeding time,and postoperative hospitalization time between two groups(P>0.05).There was no significant difference in the total incidence of postoperative complications between two groups(P>0.05).The hospitalization expenses of two groups were compared,and the difference was statistically significant(P<0.05).Conclusion Laparoscopic-assisted surgery has the same efficacy as open laparotomy in the treatment of magnetic foreign bodies in children’s digestive tract.The surgeon should choose the appropriate surgical methods according to the specific conditions.