腹腔镜辅助十二指肠-空肠吻合术治疗肠系膜上动脉综合征

目的 评价腹腔镜治疗小儿肠系膜上动脉综合征的效果.方法 2003年5月至2009年12月,采用腹腔镜辅助十二指肠-空肠Roux-en-Y吻合术治疗9例肠系膜上动脉综合征.男3例,女6例,年龄6～13岁.采用4个Trocar,腹腔镜下松解Treitz韧带,扩大脐部切口,将空肠提出离断后完成近端与远端空肠吻合;回纳空肠,将预留空肠袢在横结肠后与十二指肠扩张段腹腔镜下行Roux-en-Y吻合.结果 手术全部顺利完成,手术时间2～3.5 h,出血量(15.2±3.0))ml.术后随访5个月～6年无症状,生长发育良好.结论 腹腔镜辅助十二指肠-空肠Roux-en-Y吻合术是一种安全有效的方法,具有损伤小、住院时间短和并发症少等特点.

Laparoscopy-assisted Roux-en-Y duodenojejunostomy for superior mesenteric artery syndrome

Objective To evaluate the effectiveness of laparoscopy-assisted Roux-en-Y duodenojejunostomy for superior mesenteric artery syndrome. Methods From May 2003 to December 2009, 9 children ( age range: 6 to 13 years) with superior mesenteric artery syndrome underwent laparoscopic Roux-en-Y duodenojejunostomy. Among them, 3 were boys and 6 girls. The procedure was performed using 4 trocars. Treitzs ligament was dissected first, and the jejunojejunal anastomosis was achieved by exteriorizing the proximal jejunum through the umbilical incision. Then, the retrocolic Roux-en-Y duodenojejunostomy was carried out laparoscopically. Results All procedures were completed successfully. Operative time was 2 to 3.5 h, and the blood loss was (15.2 ± 3) ml. The patients had complete resolution of their preoperative symptoms and a normal growth and development at 5-72 months follow-up. Conclusions Laparoscopic Roux-en-Y duodenojejunostomy is a safe technique for the superior mesenteric artery syndrome. It has the benefits of less post-operative pain, a shorter hospital stay, and less postoperative disability.