Liu Qianlong, Fu Jialu, Yu Qiang, Gong Wei, Li Peng, Guo Xinkui
Department of Pediatric Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, P.R. China.
Exp Ther Med. 2022 Jul 19;24(3):581. doi: 10.3892/etm.2022.11519. eCollection 2022 Sep.
Lymphatic malformation (LM) in the abdomen is uncommon in children, and the standard treatment is surgical excision. The present study aimed to evaluate the safety and efficacy of laparoscopic surgery of intra-abdominal LM in a pediatric population. The medical records of 10 children with intra-abdominal LM treated by laparoscopic resection from March 2017 to June 2021 in The Second Affiliated Hospital of Xi'an Jiaotong University (Xi'an, China) were retrospectively reviewed. Equal numbers of female and male patients were included and underwent surgery at the median age of 55 months (range, 40 days-94 months). Abdominal pain was the most frequent symptom presenting in eight patients (80%). All children were referral patients, and half of them presented to the emergency department with acute abdominal pain. All 10 of the patients benefited from laparoscopic treatment; three patients underwent extraperitoneal segmental intestinal resection and anastomosis via an enlarged umbilical incision, and two patients were converted to laparotomy because of a large retroperitoneal LM with involvement of the colon. No recurrence or complications occurred in the patients during the follow-up period with mean of 35 months (range, 11-60 months) after surgery. Overall, laparoscopic resection of intra-abdominal LM was an effective, minimally invasive therapy in the pediatric population. Segmental intestinal resection is usually required to achieve the complete removal of lesions to lessen the risk for recurrence.
腹部淋巴管畸形(LM)在儿童中并不常见,标准治疗方法是手术切除。本研究旨在评估腹腔镜手术治疗小儿腹腔内LM的安全性和有效性。回顾性分析了2017年3月至2021年6月在西安交通大学第二附属医院(中国西安)接受腹腔镜切除术治疗的10例小儿腹腔内LM患者的病历。纳入的男女患者数量相等,手术时的中位年龄为55个月(范围40天至94个月)。腹痛是8例患者(80%)最常见的症状。所有患儿均为转诊患者,其中半数因急性腹痛就诊于急诊科。所有10例患者均从腹腔镜治疗中获益;3例患者经扩大脐部切口行腹膜外节段性肠切除吻合术,2例患者因巨大腹膜后LM累及结肠而中转开腹。术后平均随访35个月(范围11至60个月),患者无复发或并发症发生。总体而言,腹腔镜切除小儿腹腔内LM是一种有效、微创的治疗方法。通常需要行节段性肠切除以实现病变的完全切除,从而降低复发风险。