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儿童腹腔镜阑尾切除术:孟加拉国吉大港某单一中心的经验

Laparoscopic appendectomy in children: experience in a single centre in chittagong, bangladesh.

作者信息

Hannan Md Jafrul

机构信息

Department of Pediatric Surgery, South Point Hospital, 11 Access Road, Chotopul, Agrabad, Chittagong 4100, Bangladesh.

出版信息

Minim Invasive Surg. 2014;2014:125174. doi: 10.1155/2014/125174. Epub 2014 Mar 11.

Abstract

Background. Since the latter half of 1980s laparoscopy has become a well accepted modality in children in many surgical procedures including appendectomy. We present here the experience of laparoscopic appendectomy in children in a tertiary care hospital in Bangladesh.  Subjects & Methods. From October 7, 2005 to July 31, 2012, 1809 laparoscopic appendectomies were performed. Laparoscopy was performed in all the cases using 3 ports. For difficult and adherent cases submucosal appendectomy was performed. Feeding was allowed 6 h after surgery and the majority was discharged on the first postoperative day. The age, sex, operative techniques, operative findings, operative time, hospital stay, outcome, and complications were evaluated in this retrospective study. Results. Mean age was 8.17 ± 3.28 years and 69% were males. Fifteen percent were complicated appendicitis, 8 cases needed conversion, and 27 cases were done by submucosal technique. Mean operating time was 39.8 ± 14.2 minutes and mean postoperative hospital stay was 1.91 days. About 5% cases had postoperative complications including 4 intra-abdominal abscesses. Conclusions. Laparoscopic appendectomy is a safe procedure in children even in complicated cases.

摘要

背景。自20世纪80年代后半期以来,腹腔镜检查在包括阑尾切除术在内的许多儿童外科手术中已成为一种被广泛接受的方式。我们在此介绍孟加拉国一家三级护理医院儿童腹腔镜阑尾切除术的经验。

对象与方法。2005年10月7日至2012年7月31日期间,共进行了1809例腹腔镜阑尾切除术。所有病例均采用3个端口进行腹腔镜检查。对于困难和粘连病例,进行黏膜下阑尾切除术。术后6小时允许进食,大多数患者在术后第一天出院。在这项回顾性研究中,对年龄、性别、手术技术、手术发现、手术时间、住院时间、结果和并发症进行了评估。

结果。平均年龄为8.17±3.28岁,69%为男性。15%为复杂性阑尾炎,8例需要中转开腹,27例采用黏膜下技术完成手术。平均手术时间为39.8±14.2分钟,平均术后住院时间为1.91天。约5%的病例有术后并发症,包括4例腹腔内脓肿。

结论。即使在复杂病例中,腹腔镜阑尾切除术在儿童中也是一种安全的手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac91/3967814/a49b7d13ee4a/MIS2014-125174.001.jpg

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