腹腔镜治疗小儿复杂性阑尾炎

目的探讨腹腔镜治疗小儿复杂性阑尾炎的安全性、有效性。方法2002年1月至2007年3月我院对80例3～12岁小儿复杂性阑尾炎实施腹腔镜治疗。结果除中转开腹5例,手术全部成功,其中急性坏疽性阑尾炎45例,急性穿孔性阑尾炎25例,阑尾周围脓肿或包块10例;平均手术时间55min,术后胃肠功能恢复时间23.5h,20例术后使用止痛药,3例术后出现并发症,其中2例切口感染(其中中转开腹1例),1例脐部切口出血。平均住院时间6.5d。结论腹腔镜治疗小儿复杂性阑尾炎是一种安全的手术方式,术后并发症少,值得推广。

Laparoscopic appendectomy in children with complicated appendicitis

Objective To explore the safety and efficacy of laparoscopy in children with complicated appendicitis. Methods From January 2002 to March 2007,80 children aged 3 - 12 years underwent laparoscopic appendectomy for complicated appendicitis. The clinical data were analyzed retrospectively. Results Five patients were converted intraoperatively from laparoscopic appendectomies to open procedures. There were 45 patients with gangrenous appendicitis,25 patients with perforated appendicitis and 10 patients with appendiceal mass or abscess. The average operating time was 55 min. The time of resumption of diet was 23.5h. Twenty cases were treated with analgesics after operation. Three out of 80 patients had post-operative complications. Two patients developed wound infection. One patient developed haematoma at umbilical pert site. The average duration of hospital stay was 6.5 days. Conclusion Laparoscopic appendectomy is a safe alternative for the treatment of complicated appendicitis in children. It does not increase the incidence of complications and is worth popularizing in the clinical practice.