CAJ | 학술논문

目的：总结腹腔镜治疗小儿急性肠套叠的临床经验。方法2008年8月至2013年5月，我们对82例急性肠套叠患儿实施腹腔镜手术治疗。在腹腔镜直视下行肠套叠整复术，对于难复性肠套叠，术中辅助空气灌肠，复位后观察套叠肠管生机，探查末端回肠1 m以上及肠系膜淋巴结肿大情况，对有肠坏死或器质性病变者，扩大脐孔提出病变肠管，行肠切除肠吻合术，在腹腔镜下切除阑尾或淋巴结活检，对合并腹股沟斜疝者同时手术。结果82例中，77例腹腔镜下复位成功，5例因发现肠坏死或套叠过紧而中转开腹手术。术中发现13例有肠管器质性病变，75例非小肠套叠者予以阑尾切除术，平均手术时间6 min，5例合并腹股沟斜疝者同时行腹腔镜下疝囊高位结扎术，平均单侧手术时间5 min，总手术时间平均为52 min。术后平均随访时间2年9个月，无一例复发。结论腹腔镜治疗小儿急性肠套叠安全可靠，可清楚探查有无肠管器质性病变，对合并腹股沟斜疝可酌情同时手术治疗，效果满意，但应严格把握手术指征，熟练掌握操作流程。
목적：총결복강경치료소인급성장투첩적림상경험。방법2008년8월지2013년5월，아문대82례급성장투첩환인실시복강경수술치료。재복강경직시하행장투첩정복술，대우난복성장투첩，술중보조공기관장，복위후관찰투첩장관생궤，탐사말단회장1 m이상급장계막림파결종대정황，대유장배사혹기질성병변자，확대제공제출병변장관，행장절제장문합술，재복강경하절제란미혹림파결활검，대합병복고구사산자동시수술。결과82례중，77례복강경하복위성공，5례인발현장배사혹투첩과긴이중전개복수술。술중발현13례유장관기질성병변，75례비소장투첩자여이란미절제술，평균수술시간6 min，5례합병복고구사산자동시행복강경하산낭고위결찰술，평균단측수술시간5 min，총수술시간평균위52 min。술후평균수방시간2년9개월，무일례복발。결론복강경치료소인급성장투첩안전가고，가청초탐사유무장관기질성병변，대합병복고구사산가작정동시수술치료，효과만의，단응엄격파악수술지정，숙련장악조작류정。
Objetive To summarize the clinical experience of curing the acute intussusception in chil-dren by laparoscopy. Methods 82 cases of acute intussusception in children were operated by laparoscopy. Results 77 cases were reseted successfully by laparoscopy,5 cases were reversed to open when found intesti-nal necrosis or invagination too tight during the operation.There were 1 3 cases with structural disease were found during the operation,75 cases done appendectomy were not the intestine intussusception,the average op-eration time was 6 min,5 cases combined with oblique inguinal hernia done high ligation of hernial sac by lapa-roscopy,the average operation time was 5 min,the average time of whole operation was 52 min.The average followed up time was 33 months after the operation,and no one recured. Conclusion To hold the operating indication strictly,and keep the operation consummate,it is safely for curing acute intussusception in children by laparoscopy,exploring the organic disease weather or not after resetting the intussusception,if combined with oblique inguinal hernia,could do the operation at the same time,and the effect wis satisfaction.It is fully to reveal the superiority of exploration and mini-injury by laparoscopic operation.