腹腔镜手术切除六例小儿脐尿管囊肿的临床报告

目的探讨腹腔镜治疗小儿脐尿管囊肿的时机、方法和效果。 方法回顾性分析自2014年10月至2017年10月在中山大学附属第一医院和深圳市儿童医院小儿外科收治的6例经腹腔镜治疗的小儿脐尿管囊肿临床资料。女2例，男4例，平均年龄5岁1个月。术前均经超声和CT确定诊断，脐尿管囊肿大小为1.1～3.0 cm，4例位置近膀胱，2例在脐尿管的中间位。3例无症状的择期手术，3例有症状的在感染控制后择期手术，全部6例均采用脐部和平脐两侧腹壁进三个曲卡的方法，进行了腹腔镜脐尿管囊肿切除术。 结果本组患儿手术全部顺利完成，术中囊肿均完整无破溃，手术时间45～80 min，平均60 min。术中和术后无并发症。病理均符合诊断。随访6～43个月，6例患儿均恢复顺利，腹部切口瘢痕不明显，患儿家属满意。 结论小儿脐尿管囊肿腹腔镜下可完整切除，手术安全、有效、恢复快速，外观良好。

Clinical analysis of laparoscopic urachal cystectomy in 6 children

ObjectiveTo investigate the time, method and effect of laparoscopic treatment for urachal cyst in children. MethodsA retrospective analysis was performed by collecting clinical data of 6 patients who were treated by laparoscopic excision of urachal cyst from October 2014 to October 2017 at the Department of Pediatric Surgery in the First Affiliated Hospital of Sun Yat-Sen University and Shenzhen Children’s Hospital. Two girls and four boys, with an average age of 5 years and 1 month. Preoperative diagnoses were confirmed by ultrasound and computed tomography (CT). The size of urachal cysts was 1.1-3.0 cm; 4 cysts were near the bladder, and 2 cases were in the middle position of the urachus. 3 asymptomatic patients underwent elective surgery, while 3 symptomatic patients underwent elective surgery after infection controlled. All 6 cases underwent laparoscopic urachal cystectomy by approach of three trocars which were placed in the umbilicus and two sides of umbilical plane. ResultsAll children completed surgery successfully. The cysts were all intact without rupture during operation. The operation time was 45-80 minutes, with an average of 60 minutes. There were no intraoperative or postoperative complications. The pathological findings were accord with the diagnosis of urachal cyst. During the follow-up period of 6-43 months, all the 6 children recovered smoothly, the abdominal incision scars were not obvious, and the parents were satisfied with the cosmetic results. ConclusionsLaparoscopic resection for the treatment of children with urachal cyst is safe and effective, and has rapid recovery and cosmetic result.