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使用伤口牵开器治疗合并肝脏疝出的巨大脐膨出和腹裂破裂：一种新方法

Treatment of Ruptured Giant Omphalocele and Gastroschisis with Liver Herniation using a Wound Retractor as a Novel Approach.

作者信息

Nelson Jana, Wachowiak Robin, Siekmeyer Manuela, Knuepfer Matthias, Thome Ulrich, Holger Stepan, Lacher Martin

机构信息

Division of Pediatric Surgery, Leipzig University Hospital for Children and Adolescents, Leipzig, Saxony, Germany.

Department of Pediatric Medicine, Leipzig University Hospital for Children and Adolescents, Leipzig, Saxony, Germany.

出版信息

European J Pediatr Surg Rep. 2020 Jan;8(1):e112-e116. doi: 10.1055/s-0040-1721054. Epub 2020 Dec 15.

DOI:10.1055/s-0040-1721054
PMID:33335827
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7738231/
Abstract

Ruptured giant omphaloceles (GO) and gastroschisis with total liver herniation are rare cases of exceptionally large abdominal wall defects. Many of these children have lethal outcome. The surgical and postsurgical management are complex. We report on two cases treated with staged surgical repair using a wound retractor as a silo. With this technique, the liver and intestines could be reduced into the abdomen with secondary closure of the abdominal cavity within the first 1 to 2 weeks of life.

摘要

巨大脐膨出破裂（GO）和伴有全肝疝出的腹裂是腹壁缺损异常大的罕见病例。这些患儿中的许多都有致命结局。手术及术后管理很复杂。我们报告两例采用伤口牵开器作为“储仓”进行分期手术修复的病例。通过这种技术，肝脏和肠道可在出生后的头1至2周内回纳入腹腔，随后二期关闭腹腔。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f13/7738231/9c6e368b4c26/10-1055-s-0040-1721054-i200554cr-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f13/7738231/a6d59b6b364b/10-1055-s-0040-1721054-i200554cr-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f13/7738231/9c6e368b4c26/10-1055-s-0040-1721054-i200554cr-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f13/7738231/a6d59b6b364b/10-1055-s-0040-1721054-i200554cr-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f13/7738231/9c6e368b4c26/10-1055-s-0040-1721054-i200554cr-2.jpg

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本文引用的文献

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Repair of Ruptured Omphalocele Sac in the Neonatal Period and Beyond.新生儿期及以后脐膨出囊破裂的修复
J Indian Assoc Pediatr Surg. 2020 Jan-Feb;25(1):46-48. doi: 10.4103/jiaps.JIAPS_195_18. Epub 2019 Nov 27.
2
Ruptured omphalocele: Diagnosis and management.脐膨出破裂：诊断与处理
Semin Pediatr Surg. 2019 Apr;28(2):101-105. doi: 10.1053/j.sempedsurg.2019.04.009. Epub 2019 Apr 6.
3
Giant Gastroschisis with Complete Liver Herniation: A Case Report of Two Patients.巨大腹裂伴肝脏完全疝出：两例患者的病例报告
Case Rep Surg. 2019 Jan 15;2019:4136214. doi: 10.1155/2019/4136214. eCollection 2019.
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Early surgical management for giant omphalocele: Results and prognostic factors.巨大脐膨出的早期手术治疗：结果与预后因素
J Pediatr Surg. 2018 Oct;53(10):1908-1913. doi: 10.1016/j.jpedsurg.2018.04.036. Epub 2018 May 24.
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Predictors of mortality in neonates with giant omphaloceles.巨大脐膨出新生儿死亡的预测因素
Minerva Pediatr. 2018 Jun;70(3):289-295. doi: 10.23736/S0026-4946.17.05109-X. Epub 2017 Nov 21.
6
Intra-abdominal hypertension and abdominal compartment syndrome in pediatrics. A review.小儿腹腔内高压和腹腔间隔室综合征。综述。
J Crit Care. 2017 Oct;41:275-282. doi: 10.1016/j.jcrc.2017.06.004. Epub 2017 Jun 7.
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Management of giant omphaloceles: A systematic review of methods of staged surgical vs. nonoperative delayed closure.巨大脐膨出的管理：分期手术与非手术延迟闭合方法的系统评价
J Pediatr Surg. 2016 Oct;51(10):1725-30. doi: 10.1016/j.jpedsurg.2016.07.006. Epub 2016 Jul 27.
8
Congenital Abdominal Wall Defects: Staged closure by Dual Mesh.先天性腹壁缺损：采用双层补片分期关闭
J Neonatal Surg. 2016 Jan 1;5(1):2. eCollection 2016 Jan-Mar.
9
Negative pressure wound therapy for initial management of giant omphalocele.负压伤口治疗用于巨大脐膨出的初始处理
Am J Surg. 2016 Mar;211(3):605-9. doi: 10.1016/j.amjsurg.2015.11.009. Epub 2015 Dec 23.
10
Giant omphaloceles: surgical management and perinatal outcomes.巨大脐膨出：手术治疗及围产期结局
J Surg Res. 2015 Oct;198(2):388-92. doi: 10.1016/j.jss.2015.03.060. Epub 2015 Mar 25.