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儿童复杂性梅克尔憩室的腹腔镜治疗:一项10年回顾

Laparoscopic management of complicated Meckel's diverticulum in children: a 10-year review.

作者信息

Chan K W, Lee K H, Mou J W C, Cheung S T, Tam Y H

机构信息

Division of Paediatric Surgery and Paediatric Urology, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, 30-32 Ngan Shing Street, Hong Kong SAR, China.

出版信息

Surg Endosc. 2008 Jun;22(6):1509-12. doi: 10.1007/s00464-008-9832-0. Epub 2008 Mar 6.

Abstract

BACKGROUND

Meckel's diverticulum, the most common congenital anomaly of the gastrointestinal tract, is prone to develop complications in the pediatric population. The authors report their 10-year experience with the management of complicated Meckel's diverticulum in children using laparoscopy.

METHODS

A retrospective review of all complicated Meckel's diverticulum cases involving children from 1998 to 2007 was performed. The efficacy and safety of laparoscopy used to manage complicated Meckel's diverticulum were assessed.

RESULTS

Over a 10-year period, 20 children (17 boys and 3 girls) with a mean age of 5 years (range, 7 months to 13 years) were included in the study. Of the 20 children, 12 presented with gastrointestinal bleeding, 2 had intestinal obstruction, 3 had abdominal pain mimicking acute appendicitis, 2 had inguinal hernia, and 1 had intussusception. Diagnostic laparoscopy was performed for all the patients. Laparoscopically assisted transumbilical Meckel's diverticulectomy was performed successfully for 18 of the children. The operative time ranged from 50 to 190 min (mean, 115 min). All the children had an uneventful recovery except one, who experienced a postoperative wound infection. Ectopic gastric mucosa was found in 14 cases.

CONCLUSIONS

Diverse pediatric surgical conditions result from Meckel's diverticulum. Laparoscopy is a safe and effective method for the management of complicated Meckel's diverticulum.

摘要

背景

梅克尔憩室是胃肠道最常见的先天性异常,在儿科人群中容易发生并发症。作者报告了他们使用腹腔镜治疗儿童复杂性梅克尔憩室的10年经验。

方法

对1998年至2007年所有涉及儿童的复杂性梅克尔憩室病例进行回顾性研究。评估了腹腔镜治疗复杂性梅克尔憩室的有效性和安全性。

结果

在10年期间,20名儿童(17名男孩和3名女孩)纳入研究,平均年龄5岁(范围7个月至13岁)。20名儿童中,12例出现胃肠道出血,2例有肠梗阻,3例有类似急性阑尾炎的腹痛,2例有腹股沟疝,1例有肠套叠。所有患者均行诊断性腹腔镜检查。18名儿童成功进行了腹腔镜辅助经脐梅克尔憩室切除术。手术时间为50至190分钟(平均115分钟)。除1例术后伤口感染外,所有儿童恢复顺利。14例发现异位胃黏膜。

结论

梅克尔憩室可导致多种儿科外科疾病。腹腔镜是治疗复杂性梅克尔憩室的一种安全有效的方法。

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