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回顾性队列研究微创手术治疗小儿肠套叠。

Retrospective cohort study of minimally invasive surgical approaches for pediatric intussusception.

机构信息

Department of Pediatric Surgery, The National Hospital of Pediatrics, Hanoi, Vietnam.

College of Health Science, VinUniversity, Hanoi, Vietnam.

出版信息

Sci Rep. 2024 Nov 30;14(1):29763. doi: 10.1038/s41598-024-81654-x.

Abstract

Intussusception is a common pediatric emergency that causes significant morbidity and mortality, particularly in low- to middle-income countries. The laparoscopic management of intussusception following failed non-invasive methods remains a topic of debate. This study aims to evaluate the long-term outcomes of minimally invasive approaches for intussusception. A retrospective analysis was conducted on patients who underwent minimally invasive surgery for intussusception between January 2016 and December 2020 at our institution. Data on patient demographics, pre-operative and intra-operative variables, immediate postoperative complications, length of hospital stay, and long-term results were collected. A total of 181 patients underwent minimally invasive surgery, including 117 boys (64.6%) and 64 girls (35.4%), with a median age of 8 months (range: 2-134). The median hospital stay was 4 days. Thirty-nine patients underwent trans-umbilical mini-open reduction (MO group), while 142 had laparoscopic exploration after failed air enema reduction. Among them, 40 had successful laparoscopic reduction (LAP group), and 102 required conversion to laparoscopic-assisted mini-open reduction (LAMO group). No intra-operative or immediate postoperative complications were observed. Recurrence occurred in 13 patients (7.2%) after a median follow-up of 43 months, with 6 patients (3.3%) requiring laparoscopic adhesiolysis due to bowel adhesions. In conclusion, minimally invasive surgery for intussusception is a safe and feasible approach with excellent long-term outcomes.

摘要

肠套叠是一种常见的儿科急症,会导致较高的发病率和死亡率,尤其是在中低收入国家。对于非侵入性方法治疗失败的肠套叠,腹腔镜治疗仍然存在争议。本研究旨在评估微创方法治疗肠套叠的长期效果。对 2016 年 1 月至 2020 年 12 月在我院接受微创治疗肠套叠的患者进行回顾性分析。收集患者的人口统计学、术前和术中变量、术后即刻并发症、住院时间和长期结果的数据。共 181 例患者接受微创治疗,其中男 117 例(64.6%),女 64 例(35.4%),中位年龄为 8 个月(范围:2-134 个月)。中位住院时间为 4 天。39 例患者接受经脐小切口微创复位(MO 组),142 例患者在空气灌肠复位失败后行腹腔镜探查。其中,40 例成功行腹腔镜复位(LAP 组),102 例需要转为腹腔镜辅助小切口微创复位(LAMO 组)。术中及术后即刻均无并发症发生。中位随访 43 个月后,13 例患者(7.2%)出现复发,其中 6 例(3.3%)因肠粘连需行腹腔镜粘连松解术。总之,微创治疗肠套叠是一种安全可行的方法,具有良好的长期效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2992/11606937/1e1f905d7f4a/41598_2024_81654_Fig1_HTML.jpg

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