Wu Ming-Hsun, Hsu Wen-Ming, Lin Wen-Hsi, Lai Hong-Shiee, Chang King-Jen, Chen Wei-Jao
Department of Surgery, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei, Taiwan.
J Formos Med Assoc. 2002 Feb;101(2):152-5.
Ladd's procedure for laparoscopic repair of malrotation has many advantages over conventional surgical techniques, such as earlier feeding and discharge. However, this procedure is still not commonly used in Taiwan. This report describes the results of treatment of intestinal malrotation in three patients using laparoscopic Ladd's procedure. The patients, aged 8 days, 17 days, and 3 years, underwent laparoscopic Ladd's procedure between July 1999 and September 2000. All three patients had symptoms of intermittent vomiting and were shown to have intestinal malrotation by upper gastrointestinal series study. The procedure was performed using three trocars of 5 mm diameter placed at the infraumbilical ring and the right and left lower quadrants. All procedures were completed laparoscopically. The operative times were 4.8, 3.6, and 3.5 hours, respectively. Feeding was started on postoperative Day 2 to 5, and the hospital stay was 6 to 11 days. Our results suggest that laparoscopic Ladd's procedure can be performed safely in pediatric patients. In addition, patients are expected to benefit from the smaller incision, earlier feeding, shorter hospital stay, and fewer complications compared with traditional Ladd's procedure.
与传统手术技术相比，拉德氏腹腔镜修复肠旋转不良术具有诸多优势，比如可更早开始喂养和出院。然而，该手术在台湾仍未得到广泛应用。本报告描述了3例采用腹腔镜拉德氏手术治疗肠旋转不良的病例结果。这3例患者年龄分别为8天、17天和3岁，于1999年7月至2000年9月期间接受了腹腔镜拉德氏手术。所有3例患者均有间歇性呕吐症状，经上消化道系列检查证实存在肠旋转不良。手术通过在脐下环以及左右下象限放置3个直径5毫米的套管针进行。所有手术均在腹腔镜下完成。手术时间分别为4.8小时、3.6小时和3.5小时。术后第2至5天开始喂养，住院时间为6至11天。我们的结果表明，腹腔镜拉德氏手术在儿科患者中可安全实施。此外，与传统拉德氏手术相比，患者有望从更小的切口、更早的喂养、更短的住院时间以及更少的并发症中获益。
