中国微创外科杂志2015年第11期摘

腹腔镜手术治疗小儿包裹性阑尾脓肿

刘向阳陈磊李洪涛李龙

（河北医科大医院小儿外科，沧州）

目的：总结腹腔镜手术治疗小儿包裹性阑尾脓肿的临床经验。方法：年6月~年6月对36例小儿包裹性阑尾炎行腹腔镜下阑尾切除术。采用三孔法，术中分离脓腔并吸除脓液，寻找到阑尾，结扎离断系膜，双重结扎阑尾根部，切除阑尾，局部冲洗，放置引流管。结果：35例患儿顺利行腹腔镜阑尾切除术，1例因分离粘连肠管时回肠破裂中转开腹。手术时间70~min，平均84min。切口轻度感染2例，切口溢液1例，腹腔炎性包块4例，肠梗阻1例，均经保守治疗痊愈。随访31例，5例失访,2例分别在术后1、2个月因饮食不当导致肠梗阻，经禁食水、洗肠等方法治愈，余无并发症发生。结论：腹腔镜治疗小儿阑尾周围脓肿一期完成手术是安全可行的。

阑尾周围脓肿；腹腔镜手术；小儿

LaparoscopicAppendectomyforEncapsulatedAppendicealAbscessinChildrenLiuXiangyang,ChenLei,LiHongtao,etal.DepartmentofPediatricSurgery,CangzhouCentralHospitalAffiliatedtoHebeiMedicalUniversity,Cangzhou,China

ObjectiveTosummarizeourexperienceoflaparoscopicappendectomyforencapsulatedappendicealabscessinchildren.MethodsAtotalof36childrenwithappendicealabscessbetweenJuneandJuneunderwentlaparoscopicappendectomy.Threetrocarstechniquewasused.Weseparatedthepuscavityandfoundtheappendix.Afterligatinganddisconnectingtheappendixartery,doubleligationoftheappendixrootwasperformedtocuttheappendix,andadrainagetubewasplacedinthepelvicafterlocalwashing.ResultsAmongthe36children,35underwentlaparoscopicappendectomysuccessfully,whileonewasrequiredaconversiontoopenappendectomyduetoileumrupturewhenseparatingintestinaladhesion.Theoperationtimewas70-min(mean,84min).Therewere2casesofmildincisioninfection,1caseofincisionoverflow,4casesofperitonealinflammatorymass,and1caseofintestinalobstruction.Allofthemwerecuredbyconservativetreatment.Followupof31casesfound2casesofintestinalobstructionduetoimproperdiet,whichwerecuredafterfastingandcolonhydrotherapy.Noother







































白癜风治疗方法最好
白点疯