Schmidt Annika I, Engelmann Carsten, Till Holger, Kellnar Stephan, Ure Benno M
Department of Pediatric Surgery, Medical University Hanover, 30625 Hannover, Germany.
J Pediatr Surg. 2007 Sep;42(9):1491-4. doi: 10.1016/j.jpedsurg.2007.04.014.
A survey on the practice of laparoscopic and thoracoscopic surgery in pediatric surgical departments in Germany is presented.
A questionnaire was sent to all 71 pediatric surgical departments in Germany (population 82 million). Fifty institutions (70%) took part in the survey that mainly included data for the year 2004: spectrum of minimally invasive operations, quantity of procedures, conversions, major complications, number of performing surgeons and residents.
Laparoscopic techniques were used in 48 departments (96%) and thoracoscopic techniques in 37 (74%). The annual frequency of laparoscopies was less than 100 in 30 departments (62%) and more than 100 in 15 (31%). The number of thoracoscopies was less than 50 in 35 departments (73%) and more than 50 in 2 (4%). Appendectomy was offered in 45 (90%), varicocelectomy in 32 (64%), and Fowler-Stephens operation in 33 (66%). Twenty-one departments (42%) covered more advanced procedures such as laparoscopically assisted pull-through for Hirschsprung disease. Most demanding procedures such as laparoscopic choledochal cyst resection, duodeno-duodenostomy, heminephrectomy, or pyeloplasty were offered by 10 departments (20%). Minimally invasive surgery was performed by 1 surgeon (12%) in 6 institutions and by more than 5 surgeons (14%) in 7 institutions.
Minimally invasive techniques are increasingly accepted in most German pediatric surgical institutions for a wide range of indications. However, the number of departments offering major minimally invasive procedures remains limited.
本文介绍了一项针对德国小儿外科腹腔镜和胸腔镜手术实践的调查。
向德国所有71个小儿外科科室（人口8200万）发送了一份调查问卷。五十家机构（70%）参与了此次调查，调查主要涵盖2004年的数据：微创操作范围、手术数量、中转开腹、主要并发症、手术医生和住院医生数量。
48个科室（96%）使用了腹腔镜技术，37个科室（74%）使用了胸腔镜技术。30个科室（62%）的腹腔镜手术年频率低于100例，15个科室（31%）高于100例。35个科室（73%）的胸腔镜手术数量低于50例，2个科室（4%）高于50例。45个科室（90%）开展阑尾切除术，32个科室（64%）开展精索静脉曲张切除术，33个科室（66%）开展福勒 - 斯蒂芬斯手术。21个科室（42%）开展更先进的手术，如腹腔镜辅助下先天性巨结肠拖出术。10个科室（20%）开展要求最高的手术，如腹腔镜胆总管囊肿切除术、十二指肠 - 十二指肠吻合术、半肾切除术或肾盂成形术。6家机构由1名外科医生（12%）进行微创手术，7家机构由5名以上外科医生（14%）进行微创手术。
在大多数德国小儿外科机构中，微创技术在广泛的适应症中越来越被接受。然而，提供主要微创手术的科室数量仍然有限。
