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套管针穿刺部位疝是学龄前儿童微创手术典型的术后并发症。

Trocar-site hernia as a typical postoperative complication of minimally invasive surgery among preschool children.

作者信息

Paya K, Wurm J, Fakhari M, Felder-Puig R, Puig S

机构信息

Department of Surgery, Medical University of Vienna, Waehringerguertel 18-20, Vienna, Austria.

出版信息

Surg Endosc. 2008 Dec;22(12):2724-7. doi: 10.1007/s00464-008-9768-4. Epub 2008 Feb 13.

Abstract

BACKGROUND

Minimally invasive surgery (MIS) in preschool children (<5 years of age) is not common yet, and few reports evaluating typical complications are available. Trocar site hernias are well described in adult patients but also have been reported for preschool children. The goal of our study was to determine incidence and relevance of trocar site hernias as complications of minimally invasive surgery in preschool children.

METHODS

Retrospective analysis of all pediatric patients who underwent minimally invasive surgery at a single institution. Review of the literature.

RESULTS

Trocar site hernias are significantly more frequent in preschool children than in older ones (p = 0.006). Complication rates at all are not significantly different. Trocar site hernias in infants are mainly of type 3 (omental protrusion) and occur within the first postoperative week.

CONCLUSION

Meticulous suturing of all layers (particularly the peritoneum) even in small incisions (2 mm) is recommended to prevent omental protrusion at trocar site in children up to 5 years of age.

摘要

背景

微创手术(MIS)在学龄前儿童(<5岁)中并不常见,且很少有评估典型并发症的报告。套管针穿刺部位疝在成年患者中已有充分描述,但在学龄前儿童中也有报道。我们研究的目的是确定套管针穿刺部位疝作为学龄前儿童微创手术并发症的发生率及相关性。

方法

对在单一机构接受微创手术的所有儿科患者进行回顾性分析。文献综述。

结果

学龄前儿童套管针穿刺部位疝的发生率明显高于大龄儿童(p = 0.006)。总体并发症发生率无显著差异。婴儿的套管针穿刺部位疝主要为3型(网膜突出),且发生在术后第一周内。

结论

建议对所有层次(尤其是腹膜)进行细致缝合,即使是小切口(2毫米),以防止5岁以下儿童套管针穿刺部位出现网膜突出。

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