腹腔镜手术治疗小儿阑尾周围脓肿22例报告

摘要

目的 探讨腹腔镜手术治疗小儿阑尾周围脓肿的可行性.方法 2013年4月~2016年5月行腹腔镜手术治疗阑尾周围脓肿22例,一般从侧腹壁与脓肿粘连处开始钝性分离,脓肿提起后再从网膜粘连疏松处钝性分离进入脓腔.分离阑尾,处理阑尾残端,冲洗腹腔,留置腹引管.结果 22例均一期完成腹腔镜阑尾切除术,无中转开腹.手术时间(65.3±8.2)min;术中出血量(10.5±4.2)ml;术后住院时间(6.5±1.4)d.22例术后随访6~24个月,平均12个月,均未发生腹腔脓肿、残端瘘、残株炎或粘连性肠梗阻等并发症.结论 腹腔镜治疗小儿阑尾周围脓肿可行、安全.%Objective To explore the feasibility of laparoscopic surgery in the treatment of pediatric periappendicural abscess.Methods A total of 22 cases of pediatric periappendicural abscess were treated with laparoscopic surgery from April 2013 to May 2016.In the operation, we performed the separation from the side of the abdominal wall and abscess adhesion, and then lifted the abscess for blunt separation into the abscess cavity.After the management of appendix stump, the abdominal cavity was washed and a peritoneal drainage tube was placed.Results Laparoscopic appendectomy was performed successfully in all the cases.No conversion to open laparotomy was needed.The operation time was (65.3±8.2) min, the intraoperative blood loss was (10.5±4.2) ml, and the postoperative hospitalization was (6.5±1.4) days.Follow-ups for 6-24 months (mean, 12 months) in the 22 cases found no complications, such as abdominal abscess, stump fistula, stump appendicitis or adhesive ileus.Conclusion The application of laparoscopic surgery in the treatment of pediatric periappendicural abscess is feasible and safe.