Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA.
J Pediatr Surg. 2012 Dec;47(12):2345-8. doi: 10.1016/j.jpedsurg.2012.08.013.
Laparoscopic techniques have been applied to restorative proctocolectomy since the early 2000s. We have employed a technique for laparoscopic-assisted total proctocolectomy (TPC) and ileal pouch anal anastomosis (IPAA) for the treatment of children with ulcerative colitis (UC).
A total of 68 children underwent laparoscopic-assisted TPCs at our institution from June 2003 to February 2011. The patients ranged from 5 to 22 years of age. We progressively modified our surgical approach in positioning, equipment use, and operative technique.
A total of 68 children underwent laparoscopic-assisted TPC within the 8-year time period. Two major complications occurred (2/68=3%) consisting of 1 duodenal injury and 1 small bowel injury. There were 6 minor complications (6/68=9%), including 5 stoma revisions and 1 port site hernia. There were no superficial wound infections. There were no reported cases of pouch fistulas, anastomotic breakdown, or neurovascular injuries.
Our surgical technique is safe and effective in treating children with UC.
自 21 世纪初以来，腹腔镜技术已应用于修复性直肠结肠切除术。我们采用腹腔镜辅助全直肠结肠切除术（TPC）和回肠储袋肛管吻合术（IPAA）治疗溃疡性结肠炎（UC）患儿。
2003 年 6 月至 2011 年 2 月，我院共对 68 例儿童进行了腹腔镜辅助 TPC。患者年龄 5-22 岁。我们逐步改进了手术方法，包括体位、设备使用和手术技术。
在 8 年的时间内，68 例儿童接受了腹腔镜辅助 TPC。发生了 2 例严重并发症（2/68=3%），包括 1 例十二指肠损伤和 1 例小肠损伤。有 6 例轻微并发症（6/68=9%），包括 5 例造口修复和 1 例切口疝。无浅表伤口感染。无储袋瘘、吻合口破裂或血管神经损伤的报道。
我们的手术技术治疗儿童 UC 安全有效。
