腹腔镜在小儿外科疾病中应用.docVIP

腹腔镜在小儿外科疾病中的应用 　　作者：赵永哲,李新国,王丽丽,于金刚,巴特尔　　作者单位：赤峰市第二医院，内蒙古 赤峰 　　【摘要】目的：总结应用腹腔镜技术开展小儿外科手术的经验。方法：腹腔镜手术52例，其中经后腹腔入路离断性肾盂成形术3例，肾囊肿去顶术1例，经腹腔入路行小儿腹股沟斜疝及小儿交通性鞘膜积液内环口结扎术35例，阑尾切除术6例、肾母细胞瘤破裂止血活检术1例，隐睾探查松解下降固定术6例。结果：除1例因隐睾位于近肾下极处腹腔镜手术困难中转开放手术外，其余手术均获成功。住院时间1～7d，随访1.5个月～2年，无并发症发生，疝及鞘膜积液无复发。结论：腹腔镜手术治疗小儿腹股沟斜疝、小儿交通性鞘膜积液、不能触及的隐睾、肾盂输尿管连接部狭窄等疾病时，手术效果与传统手术相同，且手术时间短，术中出血量少，切口微小，术后患儿康复快，值得临床推广。 　　【关键词】 小儿外科;腹腔镜术 　　The application of laparoscopy in pedialric surgery ZHAO Yongzhe,LI Xinguo,WANG Lili,et al.The Second Hospital of Chifeng City,Chifeng 024000,China 　　【Abstract】 ObjectiveTo summarize the experience of laparoscopy in pediatric surgery.MethodsFifty two cases were performed laparoscopic operation.The laparoscopic operative types were as followsbreaking pyeloplasty was performed through retroperitoneal cavity in 3 cases,unroofing of cyst of kidney in 1 case,ligating the orifice of inner ring through abdominal cavity for oblique inguinal hernia and communicating hydrocele of children in 35 cases,nephroblastoma rupture hemostasis and biopsy in 1 case,cryptorchidism exploration and fixation in 6 cases.ResultsAll cases of laparoscopic surgery were successful except one case,which the cryptorchidism was located in inferior pole of kidney,was diffcult for laparoscopic treatment and forced to conversion.ConclusionsThe laparoscopic operation can treat the children indirect inguinal hernia,children communicating hydrocele,enorchia and ureteropelvic junction stenosis.Its clinical effect is identical with traditional surgery.The advantage of laparoscopic operation is the shorter operative time,less bleeding,smaller incision and recovery quickly.It is worth clinical promotion. 　　【Key words】 Pediatric surgery;Laparoscopy 　　为探讨腹腔镜用于治疗小儿外科疾病的价值，2000年2月至2007年3月我院应用腹腔镜治疗小儿外科疾病52例，疗效满意，现报道如下。 　　1 资料与方法 　　1.1 临床资料 52例中男43例，女9例，1.5～14岁，平均8.5岁。其中，单侧腹股沟斜疝23例，双侧腹股沟斜疝4例，单侧隐睾5例，双侧隐睾1例，急性阑尾炎6例，单侧交通性鞘膜积液7例，双侧交通性鞘膜积液1例，腹部外伤致肾母细胞瘤破裂出血1例，单侧肾囊肿1例，肾盂输尿管连接部狭窄3例。5例隐睾术前行彩超检查，排除睾丸异