CAJ | 학술논문

目的探讨经胸腔镜手术治疗新生儿、小婴儿先天性膈疝的手术技巧及疗效.方法回顾分析2010年10月至2011年6月采用经胸腔镜手术修补治疗9例先天性膈疝病例,其中男8例,女1例,年龄1～23 d 8例,3个月1例,病变均位于左侧,术前均经摄胸部X线片获得诊断,采用3孔法实施手术,还纳疝内容后,间断缝合修补膈肌缺损或行膈肌折叠完成手术.结果 9例患儿中有疝囊6例,无疝囊3例,术毕留置胸腔负压引流4例,未引流5例,手术时间52～121min,手术出血量5～10 ml,3例患儿肺脏发育不良,所有患儿均在腔镜下顺利完成手术,术前症状完全消失,痊愈出院.术后随访1～7个月,无复发,仅1例术后3个月复诊发现修补膈面内侧上抬1个肋间,生长发育良好.结论经胸腔镜手术治疗先天性膈疝术野显露清楚、操作方便,损伤小、切口美观,近期疗效满意,远期效果需进一步随访.
목적 탐토경흉강경수술치료신생인、소영인선천성격산적수술기교급료효.방법 회고분석2010년10월지2011년6월채용경흉강경수술수보치료9례선천성격산병례,기중남8례,녀1례,년령1～23 d 8례,3개월1례,병변균위우좌측,술전균경섭흉부X선편획득진단,채용3공법실시수술,환납산내용후,간단봉합수보격기결손혹행격기절첩완성수술.결과 9례환인중유산낭6례,무산낭3례,술필류치흉강부압인류4례,미인류5례,수술시간52～121min,수술출혈량5～10 ml,3례환인폐장발육불량,소유환인균재강경하순리완성수술,술전증상완전소실,전유출원.술후수방1～7개월,무복발,부1례술후3개월복진발현수보격면내측상태1개륵간,생장발육량호.결론 경흉강경수술치료선천성격산술야현로청초、조작방편,손상소、절구미관,근기료효만의,원기효과수진일보수방.
Objective To study the feasibility of thoracoscopic repair of congenital diaphragmatic hernia (CDH)in neonates and infants.Methods Eight neonates aged1to23 days and one infant aged3 months (seven males and onefemale),underwent thoracoscopic repair of CDHunder general anesthesia with endotracheal intubation.The diagnosis was made based onchest radiograph.The herniated contentswere reduced and the hernia defect was repaired using interrupted sutures via three-port method.Results Thoracoscopicrepair were completed without intra-operative and post-operative complication in all patients.The operative time ranged from 52-121minutes.There was minimal amount of bleeding(5-10mls).No recurrence was detected during follow-up.Conclusions Thoracoscopic repair ofcongenital diaphragmatic herniais asafe and effcctiveapproach,This approach has the advantages ofreduced trauma and physiological disturbance of surgery,excellent visualisation and improved cosmesis.