Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Medical Center, 111 Michigan Avenue NW, Washington, DC 20010, USA.
Dis Esophagus. 2013 Jan;26(1):37-43. doi: 10.1111/j.1442-2050.2012.01324.x. Epub 2012 Mar 6.
Minimally invasive surgical techniques are becoming increasingly popular within the pediatric population. Flexible endoscopy may enhance or replace existing techniques in the future. Many of the reported benefits of laparoscopy and thoracoscopy may apply to endoscopy and endoscopy-assisted procedures; however, no reports exist as to the application, results, and outcomes for these procedures in children. It was hypothesized that endoscopy is a useful and safe adjunct for pediatric surgical patients. Retrospective review of medical records for patients who underwent endoscopy or endoscopy-assisted operations at two children's hospitals over 3 years (August 31, 2007-August 31, 2010) was completed. During this time period, 30 procedures were performed on 28 patients. Indications for procedure, age, operative technique, operative times, surgical outcomes, complications, and length of stay for each patient were reviewed. Patient age ranged from 3 days to 20 years. Indications for operation included esophageal pathology (13), gastroduodenal pathology (14), pancreatic pseudocyst (2), and displaced sigmoid Chait® (Cook, Inc., Bloomington, IN, USA) tube. Although endoscopy was intended only as an adjunct in all cases, the planned procedure was satisfactorily completed with a purely endoscopic approach in six cases. There were no intraoperative complications, and minor postoperative complications including one stricture requiring dilation, postoperative stridor, and esophageal leak, were each successfully managed conservatively. Endoscopy offers a promising adjunct to more traditional minimally invasive techniques in children. In some cases, endoscopy may offer an alternative to more invasive procedures or eliminate the need for tube thoracostomy or post-procedural contrast studies in some esophageal cases.
微创外科技术在儿科人群中越来越受欢迎。柔性内镜检查将来可能会增强或取代现有的技术。腹腔镜和胸腔镜的许多已报道的益处可能适用于内镜检查和内镜辅助手术；然而，对于这些儿科患者的应用、结果和结局，尚无报道。假设内镜检查是小儿外科患者的一种有用且安全的辅助手段。对两家儿童医院在 3 年期间（2007 年 8 月 31 日至 2010 年 8 月 31 日）接受内镜检查或内镜辅助手术的患者的病历进行回顾性审查。在此期间，对 28 名患者进行了 30 次手术。对每位患者的手术适应证、年龄、手术技术、手术时间、手术结果、并发症和住院时间进行了回顾。患者年龄从 3 天至 20 岁不等。手术适应证包括食管病变（13 例）、胃十二指肠病变（14 例）、胰腺假性囊肿（2 例）和移位乙状结肠 Chait®管（库克公司，印第安纳州布鲁明顿，美国）。尽管在所有情况下内镜检查仅作为辅助手段，但在 6 例中，通过纯内镜方法成功完成了计划的手术。术中无并发症，术后轻微并发症包括 1 例狭窄需扩张、术后喘鸣和食管漏，均成功保守治疗。内镜检查为儿童更传统的微创技术提供了一种很有前途的辅助手段。在某些情况下，内镜检查可能为更具侵袭性的手术提供替代方法，或者在某些食管病例中消除了需要胸腔引流管或术后对比研究的必要性。
