Li Bing, Chen Wei-bing, Wang Shou-qing, Xia Shun-lin, Liu Shu-li, Li Long
Capital Institute of Pediatrics, Beijing, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2013 Jan;16(1):44-7.
To summarize the experiences and advantages of laparoendoscopic single-site (LESS) surgery for neonatal intestinal atresia and stenosis.
Twenty patients of neonatal intestinal atresia and stenosis were treated with LESS procedure in Huai'an Women and Children's Hospital of Jiangsu Province between October 2010 and April 2012. The clinical data were retrospectively analyzed.
Among these patients, 13 were male, 7 were female. Age at admission ranged from 10 min to 1 d. Four cases were premature, and 3 were born with low birth weight (<2500 g). One was diagnosed with duodenal atresia, 1 with duodenal stenosis, 9 with jejunal atresia, 2 with jejunal stenosis, and 7 with ileal atresia. Laparoscopic exploration was performed in all the cases by transumbilical procedure, the proximal and distal ends were exteriorized from the umbilical port site for anastomosis. Twenty neonates with intestinal atresia and stenosis were performed using this new minimally invasive approach, with no cases converted to open operation or standard laparoscopy. The operative time was 35-60 (mean, 40) min. The intraoperative bleeding was 3-5 ml. Two cases were given up treatment by their parents on the second postoperative day. For the other 18 patients, oral intake started on postoperative day 5-10 (mean, 7), and discharged from hospital on the postoperative day 10-20 (mean, 13). The follow up ranged from 1 to 11 months, during which 1 case died, 3 cases were managed with conservative treatment for diarrhea or malnutrition. The other 14 cases grew up healthily.
The technique of LESS in the treatment of neonatal atresia and stenosis is simple and the outcomes are satisfactory.
总结经自然腔道内镜手术（LESS）治疗新生儿肠闭锁及狭窄的经验及优势。
回顾性分析2010年10月至2012年4月在江苏省淮安市妇幼保健院采用LESS手术治疗的20例新生儿肠闭锁及狭窄患者的临床资料。
其中男性13例，女性7例。入院年龄为10分钟至1天。4例为早产儿，3例出生时低体重（<2500g）。十二指肠闭锁1例，十二指肠狭窄1例，空肠闭锁9例，空肠狭窄2例，回肠闭锁7例。所有病例均经脐部入路行腹腔镜探查，将远近端经脐部切口提出行吻合。20例新生儿肠闭锁及狭窄患者均采用这种新的微创方法进行手术，无一例转为开放手术或标准腹腔镜手术。手术时间为35 - 60（平均40）分钟。术中出血3 - 5ml。2例患儿术后第2天家长放弃治疗。其余18例患者术后5 - 10（平均7）天开始经口进食，术后10 - 20（平均13）天出院。随访1至11个月，期间1例死亡，3例因腹泻或营养不良行保守治疗。其余14例健康成长。
LESS技术治疗新生儿肠闭锁及狭窄操作简便，效果满意。
