Yokomori K, Ohkura M, Kitano Y, Hori T, Nakajo T
Department of Pediatric Surgery, Japanese Red Cross Medical Center, Tokyo.
J Pediatr Surg. 1992 Jul;27(7):882-4. doi: 10.1016/0022-3468(92)90391-j.
This is a report of our experience with 22 cases of large unruptured omphaloceles treated by amnion inversion during the period 1973 through 1990. The method is characterized by three stages: (1) a silastic sheet is sutured directly to the skin around the amniotic membrane, under local anaesthesia, without dissection between the skin and the amnion; (2) the reduction of herniated viscera into the abdominal cavity is achieved by squeezing the sheeting using a specially modified stapler; and (3) the amniotic membrane is preserved intact, and inverted into the abdominal cavity at the time of abdominal wall closure. Of the 22 infants, 19 survived with satisfactory results. Two patients died of multiple associated anomalies, and the remaining patient died of sepsis arising at the time of the final abdominal closure. This procedure has proved to be effective and safe for high-risk patients with congenital heart diseases, anal atresia, tracheoesophageal fistula, or bronchial stenosis and prematurity. The practical aspects of the procedure, as well as its advantages and pitfalls, are illustrated.
这是一篇关于我们在1973年至1990年期间对22例大型未破裂脐膨出病例采用羊膜翻转术治疗经验的报告。该方法具有三个阶段：（1）在局部麻醉下，将硅橡胶片直接缝合至羊膜周围的皮肤，无需在皮肤与羊膜之间进行分离；（2）通过使用特制改良吻合器挤压该片材，将疝出的内脏回纳至腹腔；（3）保留羊膜完整，并在关闭腹壁时将其翻转至腹腔内。22例婴儿中，19例存活且效果满意。2例患者死于多种相关畸形，其余1例患者死于最后腹壁关闭时出现的败血症。该手术已被证明对患有先天性心脏病、肛门闭锁、气管食管瘘或支气管狭窄以及早产的高危患者有效且安全。文中阐述了该手术的实际操作要点及其优缺点。
