腹腔镜手术治疗小儿阑尾炎的临床应用

目的:探讨腹腔镜手术在小儿阑尾炎治疗中的价值与开腹手术比较的优越性.方法:回顾性分析2004～2009年10月收治的103例阑尾炎患儿的手术治疗效果.结果:本组中44例行开腹阑尾切除术,59例行腹腔镜阑尾切除术,其中4例腹腔镜中转开腹手术,所有手术均顺利完成.随访90例(87.4%),平均随访时间(6.5±3.0)个月,9例术后切口感染,延期换药2周后愈合,3例出现粘连性肠梗阻(其中2例手术治疗,1例经保守治愈,随访12个月未出现腹胀、腹痛)等梗阻症状.2例术后出现阑尾残株炎,经保守治疗2～3周后症状消失.结论:对小儿阑尾炎一旦确诊,应早期手术治疗.腹腔镜阑尾切除术治疗小儿阑尾炎安全有效,与传统开腹手术相比具有较多的优势.

Clinical application of laparoscopic treatment in pediatric appendicitis

Objective：To evaluate the experience of laparoscopic surgery in the treatment of children appendicitis and advantages compared with open surgery. Methods：A retrospective analysis was conducted on 103 operative children inpatients with appendicitis from 2004 to October 2009. Results：Routine abdominal appendectomy was in 44 cases, 59 cases received routine laparoscopie appendectomy, of which 4 cases were converted to laparotomy. All operations were completed successfully. 90 cases （87.4%） were followed up for an average follow-up period （6.5 ± 3.0） months. 9 cases had postoperative wound infection,delayed healing dressing and cured after 2 weeks ,3 cases had adhesive intestinal obstruction ,including two cases of surgical treatment, 1 case v：as conservatively cured, 12 months follow-up showed no obstructive symptoms such as abdominal distention and abdominal pain. Postoperative appendiceal stump inflammation occurred in 2 cases. After conservative treatment of 2-3 weeks,the symptoms disappeared. Conclusion：Once pediatric appendicitis is diagnosed, early surgical treatment should be given. Laparoscopic appendectomy is safe and effective treatment,which has more advantages compared with traditional open surgery.