经脐单部位腹腔镜治疗新生儿十二指肠梗阻

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英文篇名：Transumbilical Single-site Laparoscopic Surgery for Neonatal Duodenal Obstruction 作者：冯翠竹 ; 李龙 ; 马继东 ; 张艳霞 ; 王莹 ; 张悦 英文作者：Feng Cuizhu;Li Long;Ma Jidong;Department of General ( Neonatal) Surgery,Children’s Hospital,Capital Institution of Pediatrics; 关键词：新生儿 ; 十二指肠梗阻 ; 经脐手术 ; 腹腔镜手术 英文关键词：Neonate;;Duodenal obstruction;;Transumbilical surgery;;Laparoscopic surgery 中文刊名：ZWWK 英文刊名：Chinese Journal of Minimally Invasive Surgery 机构：首都儿科研究所附属儿童医院普外(新生儿)科; 出版日期：2019-01-20 出版单位：中国微创外科杂志 年：2019 期：v.19;No.214 基金：卫计委-公益性行业专项课题(201402007) 语种：中文; 页：ZWWK201901014 页数：3 CN：01 ISSN：11-4526/R 分类号：58-60

摘要

目的探讨经脐单部位腹腔镜治疗新生儿十二指肠梗阻的安全性和可行性。方法回顾性分析我院2016年9月～2018年3月13例经脐单部位腹腔镜手术治疗新生儿十二指肠梗阻的临床资料。年龄0～26 d(中位数1 d),体重2500～4400(2992±506) g。先天性肠旋转不良伴肠扭转3例,环状胰腺6例,十二指肠闭锁4例。环脐周置入3枚trocar完成手术,辅以2～3根丝线悬吊。结果 13例均完成经脐单部位腹腔镜手术,无中转手术。手术时间(126. 4±24. 3) min,术后开始吃奶时间(6. 1±2. 1) d,总住院时间(12. 6±2. 7) d。术后随访1～13个月(平均7. 5月),无吻合口狭窄及吻合口漏,无肠旋转不良肠扭转复发。脐部伤口愈合良好,瘢痕被脐部皱褶掩盖。结论经脐单部位腹腔镜手术治疗新生儿十二指肠梗阻安全可行,具有美观、微创的优势。
        Objective To evaluate the efficacy and safety of transumbilical single-incision laparoscopic treatment for neonatal duodenal obstruction. Methods We performed a retrospective review of 13 neonatal duodenal obstruction who underwent transumbilical single-site laparoscopic treatment. The age was 0-26 days( median,1 d),and the body weight was 2500-4400( 2992 ± 506) g. There were 3 cases of congenital intestinal malrotation with intestinal torsion,6 cases of annular pancreas,and 4 cases of duodenal atresia. The operation was completed through three trocars inserted around the umbilicus assisted with 2-3 suspended sutures. Results The 13 cases underwent transumbilical single-site laparoscopic treatment without conversion. The operative time was( 126. 4 ± 24. 3) min,the time of food intake after operation was( 6. 1 ± 2. 1) d,and the hospital stay was( 12. 6 ±2. 7) d. Anastomotic stricture,anastomotic leakage and recurrence of intestinal malrotation were not found in all the cases after operation. Umbilical wound healed well. All the patients were followed up from 1 month to 13 months( mean,7. 5 months). No postoperative complications occurred. Surgical scar was covered by umbilical fold without obvious scar on the body surface.Conclusion Transumbilical single-site laparoscopic treatment for neonatal duodenal obstruction is safe and feasible, bearing advantages of good cosmetic results and minimal invasion.

引文

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