摘要
目的探讨经脐单部位腹腔镜手术治疗小儿腹膜后肿物的可行性和安全性。方法腹膜后肿物患儿53例,根据手术方式分为2组,采用传统三孔法腹腔镜腹膜后肿物切除手术38例为对照组,采用经脐单部位腹腔镜腹膜后肿物切除手术15例为观察组;比较2组手术情况以及术中出血量、手术时间、术后住院时间、术后开始进食时间、术后舒芬太尼使用剂量和切口长度等。随访11~37个月,观察2组腹膜后肿物复发情况。结果2组手术过程均顺利,腹膜后肿物均完整切除,观察组手术时间[(138.67±37.42)min]长于对照组[(105.50±19.47)min](P<0.05),切口长度[(3.14±0.17)cm]短于对照组[(3.62±0.33)cm](P<0.05),术后开始进食时间[(19.60±7.69)h]早于对照组[(27.74±10.47)h](P<0.05),术后舒芬太尼使用剂量[(1.31±0.35)μg/kg]少于对照组[(1.67±0.31)μg/kg](P<0.05),术中出血量[(36.20±16.64)mL]和术后住院时间[(8.60±1.64)d]与对照组[(29.13±12.91)mL、(8.68±1.86)d]比较差异无统计学意义(P>0.05);术后中位随访时间25个月,2组患儿腹膜后肿物均无复发。结论经脐单部位腹腔镜手术治疗小儿腹膜后肿物安全、可行,符合微创外科的理念,可作为腹膜后肿物可选治疗方法。
Objective To investigate the feasibility and safety of transumbilical single-incision laparoscopic surgery for retroperitoneal tumors in children.Methods Fifty-three children with retroperitoneal tumors were divided into 15 patients undergoing transumbilical single-incision laparoscopic surgery(observation group)and 38 patients undergoing traditional three-hole laparoscopic surgery(control group).The operation conditions,intraoperative blood loss,operation lasting time,length of postoperative hospital stay,postoperative food intaking time,postoperative sufentanil dose and incision length were compared between two groups.All patients were followed up for 11 to 37 months to observe the reccurrence of retroperitoneal tumors.Results The operation was performed successfully in two groups and the retroperitoneal tumors were completely removed.The operation lasting time was longer((138.67±37.42)min),the incision was shorter((3.14±0.17)cm),the postoperative food intaking time was earlier((19.60±7.69)h),and the dose of sufentanil was smaller((1.31±0.35)μg/kg)in observation group than that in control group((105.50±19.47)min,(3.62±0.33)cm,(27.74±10.47)h,(1.67±0.31)μg/kg)(P<0.05),while the intraoperative blood loss and the length of postoperative hospital stay showed no significant differences between observation group((36.20±16.64)mL,(8.60±1.64)d)and control group((29.13±12.91)mL,(8.68±1.86)d)(P>0.05).The mean follow-up time was 25 months,and no recurrence of retroperitoneal tumors occurred in two groups.Conclusion Transumbilical single-incision laparoscopic surgery is safe and feasible for children with retroperitoneal tumors.It conforms to the concept of minimally invasive surgery and can be regarded as a choice for the treatment of retroperitoned tumors.
作者
孟庆磊
鲍俊涛
王晓晖
高建
张书峰
MENG Qinglei;BAO Juntao;WANG Xiaohui;GAO Jian;ZHANG Shufeng(Department of Pediatric Surgery,Henan Provincial People's Hospital,Zhengzhou University People's Hospital,Zhengzhou 450003,China)
出处
《中华实用诊断与治疗杂志》
2020年第12期1263-1265,共3页
Journal of Chinese Practical Diagnosis and Therapy
基金
河南省医学科技攻关计划项目(201602172)。
关键词
腹膜后肿物
经脐单部位腹腔镜
儿童
retroperitoneal tumors
tansumbilical single-incision laparoscope
children
