经脐单部位双通道腹腔镜手术治疗38例小儿急性阑尾炎

doi:10.6040/j.issn.1671-7554.0.2022.0387

摘要/Abstract

摘要： 目的探讨经脐单部位双通道腹腔镜阑尾切除术治疗小儿急性阑尾炎的可行性。方法回顾性分析2020年7月至2021年7月于山东大学附属儿童医院普外科接受经脐单部位双通道阑尾切除术(n=38)和三孔腹腔镜阑尾切除术(n=56)治疗的94例急性阑尾炎患儿的临床资料, 对经脐单部位双通道阑尾切除术(双通道组)和三孔腹腔镜阑尾切除术(三孔组)术前一般资料、手术技巧及随访效果进行分析、比较。结果在年龄、性别、白细胞数目、进食时间、住院日和术后并发症方面,经脐单部位双通道组与三孔组之间未见明显的统计学差异,在手术时间上,经脐单部位双通道组比三孔组略长;在手术花费上,经脐单部位双通道组较三孔组明显减少(P<0.05)。结论经脐单部位双通道腹腔镜阑尾切除术治疗小儿急性非包裹性阑尾炎是安全可行的,是传统三孔腹腔镜手术的补充及改进,值得临床借鉴、推广、应用。

关键词: 腹腔镜, 阑尾炎, 经脐单部位, 儿童

Abstract: Objective To explore the clinical value of transumbilical single-site double-port laparoscopic appendectomy in the treatment of acute appendicitis in children. Methods Clinical data of 94 children with acute appendicitis who underwent transumbilical single-site double-port laparoscopic appendectomy(n=38)and three-port laparoscopic appendectomy(n=56)during July 2020 and July 2021 were retrospectively analyzed. The preoperative general information, operative skills and outcomes were compared. Results No significant differences were found in age, gender, leukocyte count, liquid diet, length of stay and complications between the two groups. The two-port group had longer operation time but lower costs than the three-port group(P<0.05). Conclusion Transumbilical single-site double-port laparoscopic appendectomy is safe and feasible for pediatric acute appendicitis. Its a supplement and improvement of three-port laparoscopic surgery and can be used widely in clinic.

Key words: Laparoscopy, Appendicitis, Transumbilical single-site, Children

中图分类号:

R726.1

秦虹,张士松,胡元军. 经脐单部位双通道腹腔镜手术治疗38例小儿急性阑尾炎[J]. 山东大学学报 (医学版), 2022, 60(12): 77-81.

QIN Hong, ZHANG Shisong, HU Yuanjun. Transumbilical single-site double-port laparoscopic appendicectomy for 38 cases of pediatric acute appendicitis[J]. Journal of Shandong University (Health Sciences), 2022, 60(12): 77-81.

参考文献

[1] Snyder MJ, Guthrie M, Cagle S. Acute appendicitis: efficient diagnosis and management [J]. Am Fam Physician, 2018, 98(1): 25-33.
[2] Saluja S, Sun T, Mao J, et al. Early versus late surgical management of complicated appendicitis in children: a statewide database analysis with one-year follow-up [J]. J Pediatr Surg, 2018, 53(7): 1339-1344.
[3] Krzyzak M, Mulrooney SM. Acute appendicitis review: background, epidemiology, diagnosis, and treatment [J]. Cureus, 2020, 12(6): e8562. doi: 10.7759/cureus.8562.
[4] Ferris M, Quan S, Kaplan BS, et al. The global incidence of appendicitis: a systematic review of population-based studies [J]. Ann Surg, 2017, 266(2): 237-241.
[5] Semm K. Edoscopic appendectomy [J]. Endoscopy, 1983, 15(2): 59-64.
[6] Rentea RM, St Peter SD. Contemporary management of appendicitis in children [J]. Adv Pediatr, 2017, 64(1): 225-251.
[7] Di Saverio S, Podda M, De Simone B, et al. Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines [J]. World J Emerg Surg, 2020, 15(1): 27. doi: 10.1186/s13017-020-00306-3.
[8] Perea L, Peranteau WH, Laje P. Transumbilical extracorporeal laparoscopic-assisted appendectomy [J]. J Pediatr Surg, 2018, 53(2): 256-259.
[9] 段春胜, 周丽霞, 朱旭光, 等. 三通道单孔穿刺器在小儿腹腔镜阑尾切除术中的应用[J]. 中华普通外科学文献(电子版), 2020, 14(4): 298-300. DUAN Chunsheng, ZHOU Lixia, ZHU Xuguang, et al. Transumbilical single incision for laparoscopic appendicetomy in children using triple channel puncture device [J]. Chinese Archives of General Surgery(Electronic Edition), 2020, 14(4): 298-300.
[10] 耿金宏, 曾林文, 孔祥东, 等. 腹腔镜牵拉装置协助下模拟单孔腹腔镜阑尾切除术临床疗效分析[J]. 中国现代普通外科进展, 2019, 22(11): 862-865. GENG Jinhong, ZENG Linwen, KONG Xiangdong, et al. Clinical analysis of laparoscopic appendectomy assisted by laparoscopic pull device [J]. Chinese Journal of Current Advances in General, 2019, 22(11): 862-865.
[11] 张士松, 武玉睿, 胡元军, 等. 经脐双通道腹腔镜手术治疗小儿腹股沟斜疝的体会[J]. 腹腔镜外科杂志, 2012, 17(2): 134-136. ZHANG Shisong,WU Yurui,HU Yuanjun, et al. Tran-umbilicus laproscopic double-port hernioplasty in treatment of pediatric indirect inguinal gernia [J]. Journal of Laparoscopic Surgery, 2012, 17(2): 134-136.
[12] Fujishiro J, Watanabe E, Hirahara N, et al. Laparoscopic versus open appendectomy for acute appendicitis in children: a nationwide retrospective study on postoperative outcomes [J]. J Gastrointest Surg, 2021, 25(4): 1036-1044.
[13] Quevedo Orrego E, RoblaCostales J, Rodríguez Aceves C, et al. Neuropathic inguinal pain due to nerve injury after a laparoscopic appendectomy: first pediatric case described in the literature [J]. Childs Nerv Syst, 2021, 37(6): 1825-1830.
[14] Salö M, Järbur E, Hambraeus M, et al. Two-trocar appendectomy in children-description of technique and comparison with conventional laparoscopic appendectomy [J]. BMC Surg, 2016, 16(1): 52.
[15] Jin HY, Lee CS, Lee YS. Single incision laparoscopic appendectomy using a new multi-joint articulating instrument [J]. J Gastrointest Surg, 2021, 25(9): 2437-2438.
[16] 刘雪来, 费川, 张永婷, 等. 双钩套扎针辅助小儿单孔腹腔镜阑尾切除术[J]. 中华小儿外科杂志, 2016, 37(10): 762-766. LIU Xuelai, FEI Chuan, ZHANG Yongting, et al.Single-port laparoscopic appendectomy via inner two-hooked cannula in children [J]. Chinese Journal of Pediatric Surgery, 2016, 37(10): 762-766.
[17] Geng J, Yuan J, Kong X, et al. Laparoscopic traction device for assistance of 2-port laparoscopic appendectomy [J]. Am Surg, 2021, 87(9): 1511-1513.
[18] Currow C, Patel K, Askari A, et al. Current technical surgical practice of emergency appendicectomy: a cross-sectional survey of surgical registrars in the UK [J]. Ann R Coll Surg Engl, 2020, 102(8): 606-610.
[19] Linnaus ME, Ostlie DJ. Complications in common general pediatric surgery procedures [J]. Semin Pediatr Surg, 2016, 25(6): 404-411.
[20] Davila D, Russek K, Franklin ME Jr. Laparoscopic appendectomy: vascular control of the appendicular artery using monopolar cauterization versus clips [J]. J Laparoendosc Adv Surg Tech A, 2012, 22(2): 165-167.
[21] Antoniou SA, Mavridis D, Hajibandeh S, et al. Optimal stump management in laparoscopic appendectomy: a network meta-analysis by the minimally invasive surgery synthesis of interventions and outcomes network [J]. Surgery, 2017, 162(5): 994-1005.
[22] Yu MC, Feng YJ, Wang W, et al Is laparoscopic appendectomy feasible for complicated appendicitis a systematic review and meta-analysis [J]. Int J Surg, 2017, 40: 187-197. doi: 10.1016/j.ijsu.2017.03.022.
[23] Zhang S, Du T, Jiang X, et al. Laparoscopic appendectomy in children with perforated appendicitis: a meta-analysis [J]. Surg Laparosc Endosc Percutan Tech, 2017, 27(4): 262-266.
[24] Moriguchi T, Machigashira S, Sugita K, et al. A randomized trial to compare the conventional three-port laparoscopic appendectomy procedure to single-incision and one-puncture procedure that was safe and feasible, even for surgeons in training [J]. J Laparoendosc Adv Surg Tech A, 2019, 29(3): 392-395.
[25] Malhotra L, Pontarelli EM, Grinberg GG, Cost analysis of laparoscopic appendectomy in a large integrated healthcare system [J]. Surg Endosc, 2022, 36(1): 800-807.

相关文章 15

[1]	薛莹,周兴国,王宇,王德海,丁印鲁. 左侧巨大十二指肠旁疝1例报道[J]. 山东大学学报 (医学版), 2022, 60(8): 127-129.
[2]	曹丹凤,刘宗花,王君芝,张国翔. 女性儿童期家庭功能障碍对成年后妊娠期抑郁症状的独立和累积作用[J]. 山东大学学报 (医学版), 2022, 60(6): 97-101.
[3]	李博,刘竞芳,鲍金鹏,李祥泽,秦广洋,田虎. 三维可视化联合吲哚菁绿荧光影像技术在51例原发性肝癌腹腔镜切除术中的应用价值[J]. 山东大学学报 (医学版), 2022, 60(3): 83-88.
[4]	薛宁,郭庆伟. 儿童误吞高吸水性树脂球32例临床分析[J]. 山东大学学报 (医学版), 2022, 60(2): 65-68.
[5]	谢心怡,张阿敏,郑文宇,宁浩南,闫宪康,马辰晖,李福海. 基于准确病原的儿童大叶性肺炎炎症特点[J]. 山东大学学报 (医学版), 2022, 60(12): 52-57.
[6]	孔林笑语,孙书珍,余丽春,贾梦文. 188例儿童系统性红斑狼疮5年生存率及预后分析[J]. 山东大学学报 (医学版), 2022, 60(12): 69-76.
[7]	梁子婷,许长娟,曾荣,张锦涛,曾庆师,董亮. 9例儿童异基因造血干细胞移植后闭塞性细支气管炎综合征的临床特征[J]. 山东大学学报 (医学版), 2022, 60(12): 58-62.
[8]	张阿敏,李国盛,李福海. 儿童支原体大叶性肺炎肺泡灌洗液细胞因子与局部炎症的相关性[J]. 山东大学学报 (医学版), 2022, 60(11): 82-88.
[9]	冯鑫鑫,韩波,张丽,马孟洁,陈思宇. 长链非编码RNA NONHSAT247814.1在18例儿童心肌炎中的表达及体外细胞实验观察[J]. 山东大学学报 (医学版), 2022, 60(10): 27-32.
[10]	仲明惟,胡三元. 我国腹腔镜技术治疗肥胖症手术方式的探索[J]. 山东大学学报 (医学版), 2021, 59(9): 72-77.
[11]	王延海,刘尹莉,刘东旭. 30例骨性Ⅲ类畸形扁桃体肥大儿童扁桃体切除术后模拟上气道内部气流的变化[J]. 山东大学学报 (医学版), 2021, 59(8): 67-73.
[12]	马玉杰,黄启坤,孙丽伟,刘艳丽. 儿童嗜酸性粒细胞性胃肠炎伴胸腹水1例并文献复习[J]. 山东大学学报 (医学版), 2021, 59(7): 125-128.
[13]	王璐,赵新蕊,朱琳. 25例早期宫颈癌无瘤化免举宫腹腔镜子宫切除术临床效果[J]. 山东大学学报 (医学版), 2021, 59(6): 76-80.
[14]	袁媛,徐翠萍,张吉甜. 腹部闭合伤并发高位肠瘘患儿的营养支持1例[J]. 山东大学学报 (医学版), 2021, 59(5): 119-121.
[15]	周子芙,张瑾,王耸,李志宇,冶小云,毕见海,徐广琪,张健,吕仁荣,霍然. 78例儿童先天性面部色素痣分期切除结合外扩张的美容效果[J]. 山东大学学报 (医学版), 2021, 59(2): 71-75.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed