目的 探讨经脐单部位腹腔镜辅助阑尾提出切除治疗儿童非包裹性阑尾炎的可行性。方法 2022年6月～2023年12月，对30例小儿非包裹性阑尾炎(2～6岁)实施经脐单部位腹腔镜辅助阑尾提出切除。脐正中置入5 mm trocar和30°腹腔镜，脐下缘置入5 mm trocar和操作钳，探查找到病变阑尾，腹腔镜无创抓钳钳夹阑尾头端或中央，电刀切开两trocar孔之间的组织，提出阑尾和盲肠末端至腹壁外，结扎阑尾根部和阑尾系膜，电钩离断阑尾。结果 30例手术时间15～22 min，(18。0±2。5)min。术后6～8 h可下床走动;术后1天内排气并进流食。术后住院2～5 d，平均3。5 d。随访1～15个月，平均4。5月，均无切口感染、粘连性肠梗阻、盆腔脓肿等并发症发生。结论 经脐单部位腹腔镜辅助阑尾提出切除是有效的阑尾切除方法，操作灵活、流畅，适用于非包裹性阑尾炎。
Transumbilical Single-site Laparoscopy Assisted Extracorporeal Appendectomy for Non-encapsulated Appendicitis in Children
Objective To explore the feasibility of a modified technique of extracorporeal appendectomy assisted by transumbilical single-site laparoscopy for non-encapsulated appendicitis in children.Methods Between June 2022 and December 2023,extracorporeal appendectomy assisted by transumbilical single-site laparoscopy was performed in our department for non-encapsulated appendicitis in 30 children(aged from 2 to 6 years old).A 5 mm trocar and a 30° laparoscope were inserted in the center of the umbilicus,and a 5 mm trocar and operating forceps were inserted at the lower edge of the umbilicus.The diseased appendix was explored and located.Non-invasive laparoscopic grasping forceps were used to clamp the head or center of the appendix.The tissue between the two trocar ports was cut open with the use of an electric knife.The appendix and distal cecum were pulled out of abdominal cavity to ligate the appendix root and mesentery.Then the appendix was disconnected with an electric hook.Results The operating time of the 30 cases was 15-22 min(average,18.0±2.5 min).Patients got out of bed and walked around at 6-8 h after surgery,and passed flatus and consumed liquid food within 1 d after surgery.Postoperative hospitalization was 2-5 d(average,3.5 d).Follow-ups for 1-15 months(average,4.5 months)showed no complications such as incision infection,adhesive intestinal obstruction,or pelvic abscess.Conclusion Transumbilical single-site laparoscopy assisted extracorporeal appendectomy is an effective procedure to resect the appendix,with characteristics of handy and convenient performance,being suitable for non-encapsulated appendicitis.
万方数据
维普
