University of Alabama at Birmingham, Birmingham, AL 35233, USA.
J Pediatr Surg. 2012 Jun;47(6):1084-8. doi: 10.1016/j.jpedsurg.2012.03.008.
The study aim was to determine outcomes of children with congenital heart disease who underwent laparoscopic procedures.
A single-institution, institutional review board-approved, retrospective review was conducted including children younger than 5 years with congenital heart disease who underwent laparoscopic or open abdominal procedures. Patient demographics, operative details, complications, and 30-day mortality were examined.
Over 10 years, 111 children with congenital heart disease underwent 121 laparoscopic procedures. Median age was 2.5 months, with 87% being infants. Laparoscopic gastrostomy was the most common procedure (101). There was no intraoperative hemodynamic instability, median operative time was 70 minutes, postoperative complications were low (5%), and all children were alive at 30 days. Only 8 patients required conversion from laparoscopic to open, all secondary to technical issues, not hemodynamic instability. There were 42 children with cardiac disease who underwent 45 open procedures during the study period. There were no significant differences between patient demographics, type of procedure, operative time, complications, or 30-day mortality comparing the open and laparoscopic groups.
In this review, there were no major contraindications to performing laparoscopic procedures in children with congenital heart disease, and we conclude that it is reasonably safe to perform laparoscopic surgery on these children.
本研究旨在确定接受腹腔镜手术的先天性心脏病儿童的治疗结果。
进行了一项单中心、机构审查委员会批准的回顾性研究,包括接受腹腔镜或开放性腹部手术的年龄小于 5 岁的先天性心脏病儿童。研究人员分析了患者的人口统计学资料、手术细节、并发症和 30 天死亡率。
10 年来,共有 111 例先天性心脏病患儿接受了 121 例腹腔镜手术。中位年龄为 2.5 个月,87%为婴儿。腹腔镜胃造口术是最常见的手术(101 例)。术中无血流动力学不稳定,中位手术时间为 70 分钟,术后并发症发生率低(5%),所有患儿在 30 天时均存活。只有 8 例患儿需要从腹腔镜转为开放性手术,均因技术问题而非血流动力学不稳定所致。在此期间,有 42 例心脏病患儿接受了 45 例开放性手术。与开放性组相比,两组患儿的人口统计学资料、手术类型、手术时间、并发症或 30 天死亡率无显著差异。
在本研究中,先天性心脏病患儿行腹腔镜手术无明显禁忌证,我们认为对这些患儿行腹腔镜手术是较为安全的。