Ure B M, Metzelder M L, Kellnar S, Till H
Kinderchirurgische Klinik, Medizinische Hochschule Hannover, Hannover.
Zentralbl Chir. 2008 Dec;133(6):535-8. doi: 10.1055/s-2008-1077018. Epub 2008 Dec 17.
Minimally invasive techniques are well established in numerous paediatric surgical departments. They are safely applied to children of all age groups. Numerous types of procedures have been established specifically for children and, therefore, the necessary expertise cannot be derived from general surgical experience. Advantages in postoperative symptoms, convalescence and cosmesis have been confirmed. However, data or recommendations concerning the use outside of centres of paediatric surgery are lacking. In the opinion of the authors, minimally invasive paediatric surgery should only be considered for departments with a volume of paediatric specialty operations similar to that of paediatric surgical centres. In addition, an adequate number of operations, specific expertise of the surgeons in minimally invasive paediatric surgery, and specific expertise of anaesthesiologists is mandatory. Today, these prerequisites can only be assumed for non-paediatric specialty operations, such as laparoscopic appendectomy. In conclusion, before recommendations can be made for minimally invasive techniques in specialty paediatric operations outside of paediatric surgical centres, the feasibility and safety under these conditions has to be investigated.
微创技术在众多小儿外科科室已得到广泛应用。它们被安全地应用于各个年龄段的儿童。已经专门为儿童建立了多种手术方式，因此，所需的专业技能无法从普通外科经验中获取。术后症状、康复情况及美容效果方面的优势已得到证实。然而，缺乏关于在小儿外科中心以外使用的相关数据或建议。作者认为，只有小儿专科手术量与小儿外科中心相似的科室，才应考虑开展微创小儿外科手术。此外，足够数量的手术、外科医生在微创小儿外科方面的专业技能以及麻醉医生的专业技能是必不可少的。如今，对于非小儿专科手术，如腹腔镜阑尾切除术，这些前提条件才能得到满足。总之，在能够对小儿外科中心以外的小儿专科手术中的微创技术给出建议之前，必须先研究在这些条件下的可行性和安全性。
