CAJ | 학술논문

目的探讨腹腔镜联合手术在小儿腹部外科中的应用价值.方法回顾性分析我院2003年1月至2011年8月行腹腔镜联合手术患儿共21例,其中包括腹腔镜脾切除+胆囊切除4例；腹腔镜小肠梅克尔憩室切除+阑尾切除4例；腹腔镜胆囊切除+阑尾切除3例；腹腔肿物活检+阑尾切除1例；腹腔镜卵巢冠囊肿剥除+阑尾切除4例；腹腔镜卵巢畸胎瘤切除+阑尾切除2例；腹腔镜食管裂孔疝修补+胃折叠+乙状结肠部分切除1例；腹腔镜疝内环缝扎+对侧精索内静脉高位结扎1例；腹腔镜疝内环缝扎+对侧睾丸切除1例.结果 21例患儿均在完全腹腔镜下顺利完成多脏器联合手术,无中转开腹病例,无术中及术后并发症的发生.手术时间40～165 min,平均(75±8.6)min.术后住院时间3～7 d,平均(5.4±1.5)d.结论腹腔镜联合手术应用于小儿腹部多脏器疾病的诊治是安全可靠的.联合手术在单次麻醉的条件下同时进行了多病灶的手术治疗,减轻了患儿的手术创伤,体现了腹腔镜手术的微创优势,同时节约了医疗成本.
목적 탐토복강경연합수술재소인복부외과중적응용개치.방법 회고성분석아원2003년1월지2011년8월행복강경연합수술환인공21례,기중포괄복강경비절제+담낭절제4례；복강경소장매극이게실절제+란미절제4례；복강경담낭절제+란미절제3례；복강종물활검+란미절제1례；복강경란소관낭종박제+란미절제4례；복강경란소기태류절제+란미절제2례；복강경식관렬공산수보+위절첩+을상결장부분절제1례；복강경산내배봉찰+대측정색내정맥고위결찰1례；복강경산내배봉찰+대측고환절제1례.결과 21례환인균재완전복강경하순리완성다장기연합수술,무중전개복병례,무술중급술후병발증적발생.수술시간40～165 min,평균(75±8.6)min.술후주원시간3～7 d,평균(5.4±1.5)d.결론 복강경연합수술응용우소인복부다장기질병적진치시안전가고적.연합수술재단차마취적조건하동시진행료다병조적수술치료,감경료환인적수술창상,체현료복강경수술적미창우세,동시절약료의료성본.
Objective To study the feasibility of combined laparoscopic surgery for the treatment of abdominal multi-organ diseases in children.Methods From January 2003 to August 2011,21children who underwent combined laparoscopic surgery in the treatment of abdominal multi-organ diseases were recruited in this study.Among these patients,laparoscopic splenectomy plus cholecystectomy were performed on 4 patients,laparoscopic small intestine diverticulectomy plus appendectomy on 4,laparoscopic cholecystectomy plus appendectomy on 3,laparoscopic tumor biopsy plus appendectomy on 1,laparoscopic excision of ovarian cyst plus appendectomy on 4,laparoscopic excision of teratoma of ovary plus appendectomy on 2,laparoscopic esophageal hiatal hernia repair with fundoplication plus partial sigmoidectomy on 1,laparoscopic hernia repair plus contralateral ligation of internal spermatic vein on 1,and laparoscopic hernia repair plus contralateral orchiectomy on 1.Results All procedures were performed successfully without conversion to open surgery and no complication was noted.The operating time was 40-165 min (mean,75±8.6 min).The length of postoperative hospital stay was 3-7 days (mean,5.4±1.5 days).Conclusions Combined laparoscopic operation can be performed safely and effectively for the treatment of abdominal multi-organ diseases in children.It can reduce the medical cost,the trauma of multiple surgeries and anesthesia exposure.