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单孔腹腔镜手术在儿童不明原因消化道出血诊治中的应用

Single-incision laparoscopic surgery in diagnosis and treatment for gastrointestinal bleeding of obscure origin in children.

作者信息

Tam Yuk Him, Chan Kin Wai, Wong Yuen Shan, Houben Christopherus H, Pang Kristine Kit Yi, Tsui Siu Yan, Mou Jennifer Wai Cheung, Lee Kim Hung

机构信息

Department of Surgery, Division of Paediatric Surgery and Paediatric Urology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.

出版信息

Surg Laparosc Endosc Percutan Tech. 2013 Jun;23(3):e106-8. doi: 10.1097/SLE.0b013e3182806517.

Abstract

In this multimedia manuscript with video presentation, we reported our experience of performing single-incision laparoscopic surgery (SILS) on 3 children who presented with gastrointestinal bleeding from congenital small bowel lesions. Preoperative investigations including endoscopy and technetium scintigraphy were all negative in the 3 patients aged 4, 7, and 10 years, respectively. SILS was performed using reusable 3- and 5-mm ports and standard straight instruments. The small bowel lesions were located by SILS and the bowel segment with the pathology was exteriorized through the umbilical wound for extracorporeal resection. The diagnoses of the 3 children were Meckel's diverticulum, ileal duplication cyst, and multiple small bowel vascular malformations. All the 3 children recovered uneventfully from surgery without any complications and required minimal postoperative analgesia. Our experience suggested that SILS is an effective alternative to conventional laparoscopy in both diagnostic and therapeutic functions for children with gastrointestinal bleeding of obscure origin.

摘要

在这份带有视频展示的多媒体稿件中,我们报告了对3例因先天性小肠病变导致胃肠道出血的儿童进行单孔腹腔镜手术(SILS)的经验。术前检查包括内镜检查和锝闪烁扫描,这3例分别为4岁、7岁和10岁的患儿结果均为阴性。使用可重复使用的3毫米和5毫米端口以及标准直器械进行SILS。通过SILS定位小肠病变,并将有病变的肠段经脐部伤口拖出进行体外切除。这3名儿童的诊断分别为梅克尔憩室、回肠重复囊肿和多发性小肠血管畸形。所有3名儿童术后恢复顺利,无任何并发症,术后所需镇痛药物极少。我们的经验表明,对于不明原因胃肠道出血的儿童,SILS在诊断和治疗功能方面是传统腹腔镜手术的有效替代方法。

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