CAJ | 학술논문

目的:探讨婴幼儿腹部手术经脐入路这一微创方法的可行性与实用性.方法:沿肚脐右侧环形皱襞作半环形切开,最大不超过270,经腹直肌或中线剪开腹膜,拖出病变或在切口处直视下进行手术操作,可吸收线皮内缝合脐部切口.结果:2001年1月～2005年1月,57例患儿经脐行58项手术,手术时间20～170min,无1例需扩大皮肤切口或转为传统开腹术.除术后1例小肠闭锁新生儿出现吻合口瘘,无其他并发症.术后5～7d愈痊出院,随访3月～4年,切口美观,无脐疝发生.结论:婴幼儿腹部手术经脐入路安全、简便、微创、美观、实用,适用于多种腹部疾病,在其它手术范围年龄及其他系统疾病都有很好的应用前景.
목적:탐토영유인복부수술경제입로저일미창방법적가행성여실용성.방법:연두제우측배형추벽작반배형절개,최대불초과270,경복직기혹중선전개복막,타출병변혹재절구처직시하진행수술조작,가흡수선피내봉합제부절구.결과:2001년1월～2005년1월,57례환인경제행58항수술,수술시간20～170min,무1례수확대피부절구혹전위전통개복술.제술후1례소장폐쇄신생인출현문합구루,무기타병발증.술후5～7d유전출원,수방3월～4년,절구미관,무제산발생.결론:영유인복부수술경제입로안전、간편、미창、미관、실용,괄용우다충복부질병,재기타수술범위년령급기타계통질병도유흔호적응용전경.
Objective:The feasibility of a minimally invasive cosmetic transbilical laparotomy was studied in fifty-seven pediatric patients.The advantages of this technique will be discussed.Methods:The circumferential incision was made following the ring fold of the right umblilicus,which was less than 2700.The peritoneum was opened in the midline via rectus abdominis.Intra-peritoneal lesions were detected and explored.The surgical procedures were able to be carried out either inside or outside of the peritoneum.After closure of peritoneum,the umbilical incision was closed subcutaneously with an absorbable suture.Results:From January 2001 to January 2005,58 procedures via transumbilical route have been done in 57 pediatric patients.None of those cases required conversion to a traditional abdominal incision.The duration of surgery was from 20 to 170 minutes.All patients were discharged five days postoperatively and follow-up was conducted from 3 months to 4 years.No complications were observed in all but one patient.This patient had a leaking anastamosis.No visible scars were present and the cosmetic results were excellent.All patients had shorter hospital stay and lower operating cost.Conclusion:Transumbilical approach is a feasible,safe,economical,minimally invasive procedure with excellent cosmetic results which appears to be superior to traditional procedures.It suggests that the transumbilical route should be widely used clinically and might be applicable for elder children and possibly would be of benefit in the treatment of other conditions.