两孔法腹腔镜手术诊治婴幼儿美克尔憩室

目的探讨两孔法腹腔镜辅助下诊治婴幼儿美克尔憩室的临床效果及应用价值。方法回顾性分析72例实施美克尔憩室切除术的患儿临床资料，按手术方式分为两孔法腹腔镜组（LD组）和剖腹切除手术组（OD组）。LD组采取头低脚高左侧倾斜位，于脐环下缘及左下腹分别置人5mm Trocar，从回盲部开始探查小肠，找到憩室后，延长脐部切口，将憩室提出腹腔外行切除吻合。OD组取右侧探查切口，找到憩室后切除。结果LD组均顺利完成腹腔镜辅助手术，无中转开腹手术病例。两组患儿手术时间、肠功能恢复时间、住院天数及术中出血量比较，差异有统计学意义（P〈0．05）；LD组优于OD组。结论两孔法腹腔镜技术行美克尔憩室切除术，可充分发挥腹腔镜下探查的优势，减少剖腹探查的盲目性，减少对肠道的干扰，防止肠粘连，创伤少，恢复快，切口美观，安全可行。

Two-port Laparoscopy-assisted Resection of the Meckel's Diverticulum in Chil dren.

Objective To investigate the clinical effect and value of two-port laparoseopy-assisted resec- tion of the Meckel＇ s Diverticulum in children. Methods The clinic date of 72 patients with Meckel＇ s Diver- ticulum were retrospectively. The patients were divided into laparoscopic diverticulectomy （ LD, 32 cases ） and open diverticulectomy（ OD ,40 cases） group. Two 5 mm trocars were respectively introduced at the infraumbili- cal ring and the left low abdomen in the LD group. When the Meckel＇ s Diverticulum was found, the incision was prolonged, the diverticulum was removed externally and the intestine was anastomosed. In the OD group, the diverticulum was finded and removed through the right abdomen cut. Results In LD group the operation was completed successfully without conversion to open surgery. LD were better than OD in terms of duration of operation, bowel function recovery time, blood loss and postoperative hospital stay, which were statistically sig- nificant between the two groups （ P 〈 0.05 ）. Conclusions Two-port laparoscopy assisted resection of Meckel＇ s Diverticulum is safe and feasible for children. The recovery time and hospital stay are short after the procedure and the incidence of postoperative complications such as ankylenteron could be prevented because LD can di- minish interference of the gut.