Gong Hong-Lei, Yang Na, Zhao Qing-Kai, Zhao Ji-Cun, Wu He
Department of General Surgery, Women and Children's Hospital, Qingdao University, Qingdao, China.
Pediatric Intensive Care Unit (PICU), Women and Children's Hospital, Qingdao University, Qingdao, China.
J Minim Access Surg. 2023 Apr-Jun;19(2):252-256. doi: 10.4103/jmas.jmas_97_22.
In the present study, we report a retrospective analysis of 23 cases of conjunctival congestion after laparoscopic operation in children and try to explore the causes and intervention measures.
This is a retrospective, single-centre and observational study, and all patients with conjunctival congestion after laparoscopic operation admitted to our institution between August 2021 and December 2021 were included in this study. Records of 23 patients including 16 male patients and 7 female patients were retrospectively analysed. These patients were in the age group of 2-12 years. Their primary symptom was different degrees of conjunctival congestion, and the symptom onset was between 2 and 7 days after laparoscopic operation, including laparoscopic inguinal hernia repair, laparoscopic appendectomies, laparoscopic Meckel's diverticulectomy, laparoscopic removal of foreign body ingestions and laparoscopic choledochal cystectomy, and the duration of operations varies from 20 min to 255 min. The symptom disappeared from 5 to 21 days after the operation, and the duration of the symptom ranged from 2 to 14 days. A total of 1718 operations were performed, of which 461 were laparoscopic and 1257 were general operations, the incidence of conjunctival congestion after laparoscopic surgery was 23/461, and compared with 0/1257 after ordinary surgery, there was a significant difference between them. Of these 23 patients, 5 patients received no treatment and the other 18 patients were intervened with steroid-containing eye drops. Although eye drops containing steroids can significantly relieve eye discomfort, the duration of conjunctival congestion between the two groups (i.e. steroid-containing eye drop treated vs. non-steroid-containing eye drop treated) did not differ significantly. All patients recovered well. In the follow-up till the end of February 2022, no serious complications had occurred.
Conjunctival congestion after laparoscopic operation is extremely rare in children, and the underlying causes are still unclear. We speculate that the pressure of pneumoperitoneum may be the main cause of this phenomenon. Symptoms may be self-limiting, and steroid-containing eye drops can relieve effectively the discomfort.
在本研究中，我们对23例儿童腹腔镜手术后结膜充血病例进行回顾性分析，试图探究其原因及干预措施。
这是一项回顾性、单中心观察性研究，纳入了2021年8月至2021年12月期间在我院接受腹腔镜手术后出现结膜充血的所有患者。对23例患者（包括16例男性和7例女性）的记录进行回顾性分析。这些患者年龄在2至12岁之间。其主要症状为不同程度的结膜充血，症状出现在腹腔镜手术后2至7天，手术包括腹腔镜腹股沟疝修补术、腹腔镜阑尾切除术、腹腔镜美克尔憩室切除术、腹腔镜取出异物摄入物以及腹腔镜胆总管囊肿切除术，手术时长从20分钟至255分钟不等。症状在术后5至21天消失，症状持续时间为2至14天。共进行了1718例手术，其中461例为腹腔镜手术，1257例为普通手术，腹腔镜手术后结膜充血的发生率为23/461，与普通手术后的0/1257相比，两者存在显著差异。这23例患者中，5例未接受治疗，其他18例患者使用含类固醇眼药水进行干预。尽管含类固醇眼药水可显著缓解眼部不适，但两组（即使用含类固醇眼药水治疗组与未使用含类固醇眼药水治疗组）结膜充血的持续时间差异不显著。所有患者恢复良好。截至2022年2月底的随访中，未发生严重并发症。
儿童腹腔镜手术后结膜充血极为罕见，其潜在原因仍不清楚。我们推测气腹压力可能是导致这种现象的主要原因。症状可能具有自限性，含类固醇眼药水可有效缓解不适。
