Nwokoma Ngozi J, Hassett Sinead, Tsang Thomas T
Department of Paediatric Surgery, Norfolk and Norwich University Hospital, Norwich, UK.
Surg Laparosc Endosc Percutan Tech. 2009 Dec;19(6):511-3. doi: 10.1097/SLE.0b013e3181bd94f8.
PURPOSE: To present our experience of the occurrence of trocar site adhesions in children following laparoscopic procedures. METHODS: Retrospective case notes review of children who were found to have trocar site adhesions at repeat laparoscopy over a 10-year period between 1998 and 2008. RESULTS: All 26 patients who had 28 episodes of repeat laparoscopic procedures were included in the study. There were 11 different procedures. Patient demographics and time interval between the procedures were noted. Trocar site to omentum or bowel adhesions were observed in 3 (10.7%) of the 28 episodes of laparoscopy. In 1 case (3.6% of the total), there were symptoms of small bowel obstruction that required laparoscopic adhesiolysis. The occurrence of adhesions following laparoscopic procedures was found to increase with the number of trocars used. CONCLUSIONS: Our results buttress the claim that the risk of adhesion formation after laparoscopic surgery in children is low. The reduction in the number of trocars used seems to further reduce this risk.
目的:介绍我们在儿童腹腔镜手术后套管针穿刺部位粘连发生情况方面的经验。 方法:对1998年至2008年10年间在重复腹腔镜检查时发现有套管针穿刺部位粘连的儿童病例记录进行回顾性研究。 结果:本研究纳入了所有26例接受28次重复腹腔镜手术的患者。共进行了11种不同的手术。记录了患者的人口统计学资料以及两次手术之间的时间间隔。在28次腹腔镜检查中有3次(10.7%)观察到套管针穿刺部位与网膜或肠管粘连。其中1例(占总数的3.6%)出现小肠梗阻症状,需要进行腹腔镜粘连松解术。发现腹腔镜手术后粘连的发生随着所用套管针数量的增加而增多。 结论:我们的结果支持了儿童腹腔镜手术后粘连形成风险较低这一观点。减少所用套管针的数量似乎可进一步降低这种风险。
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