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新生儿单孔腹腔镜辅助结肠造口术

Single trocar laparoscopic-assisted colostomy in newborns.

作者信息

Liem N T, Quynh T A

机构信息

Department of Surgery, National Hospital of Pediatrics, 18/879 La Thanh Road, Dong Da District, Hanoi, Vietnam.

出版信息

Pediatr Surg Int. 2013 Jun;29(6):651-3. doi: 10.1007/s00383-013-3299-3. Epub 2013 Mar 24.

Abstract

To present the technique and outcomes of single trocar laparoscopic-assisted colostomy in newborns. A rectangular skin flap was developed at the left subcostal area and detached from the fascia. Then the fascia and peritoneum were opened longitudinally around 11 mm, and then a 10-mm trocar was inserted into the abdominal cavity. The 10-mm operating laparoscope (Stema, Germany) was inserted through the trocar. The left transverse colon was inspected, grasped and brought outside the abdominal cavity with a Babcock grasper. The skin flap was inserted through a window created at the colon mesentery and secured to the opposite side to elevate the colon. A loop colostomy was performed. From August 2009 to December 2011, single trocar laparoscopic-assisted colostomy was performed for 39 newborns with anorectal malformations, including 26 boys and 13 girls. Mean operative time was 24 ± 4 min (range 20-30 min). There were no perioperative deaths or complications. Mean postoperative stay was 3 ± 0.6 days. Single trocar laparoscopic-assisted colostomy is a feasible and safe procedure in newborns.

摘要

介绍新生儿单孔腹腔镜辅助结肠造口术的技术及结果。在左肋下区域制作一个矩形皮瓣,并从筋膜上分离下来。然后纵向切开筋膜和腹膜约11毫米,接着将一个10毫米的套管针插入腹腔。通过该套管针插入10毫米的手术腹腔镜(德国施塔玛公司生产)。检查左横结肠,用巴布科克抓钳抓住并将其带出腹腔。将皮瓣通过在结肠系膜处创建的窗口插入,并固定到对侧以抬高结肠。进行了袢式结肠造口术。2009年8月至2011年12月,对39例患有肛门直肠畸形的新生儿进行了单孔腹腔镜辅助结肠造口术,其中男孩26例,女孩13例。平均手术时间为24±4分钟(范围20 - 30分钟)。无围手术期死亡或并发症。术后平均住院时间为3±0.6天。单孔腹腔镜辅助结肠造口术在新生儿中是一种可行且安全的手术。

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