【摘要】 目的探讨直线切割闭合器在小儿消化道手术中应用的有效性、安全性及可行性。方法2012年5月至2016年7月间本院使用直线切割闭合器实施消化道手术共332例,其中251例胆道闭锁和胆总管囊肿患儿行三角吻合术(胆道闭锁217例,胆总管囊肿34例),52例行肠造瘘术,21例各种血液病伴脾肿大患儿行脾切除术,1例脾脓肿行脾及胰尾切除术,4例回肠美克尔憩室行憩室切除术,2例幽门瘢痕狭窄行胃空肠吻合术,1例食管下端狭窄行狭窄段切除+食管胃吻合术。332例中,实施腹腔镜手术114例,传统开放手术218例。结果除初期使用切割闭合器实施胆道闭锁手术的患儿发生吻合口瘘2例,吻合口狭窄1例,早期粘连性肠梗阻1例以外,其余患儿随访1个月至4年,无一例闭合器相关并发症发生。结论使用切割闭合器进行儿童消化道手术简便,安全,有效,值得临床推广应用。更多还原

【Abstract】 Objective To explore the clinical efficacy,feasibility and safety of a linear cutting closer for pediatric gastrointestinal surgery. Methods From May 2012 to July 2016,332 hospitalized patients underwent surgery by a linear cutting closer,including 251 cases of triangle anastomosis( biliary atresia,n = 217;common bile duct cyst,n = 34). Among 52 cases of intestinal colostomy,there were splenectomy for hematonosis with splenomegaly( n = 21),spleen and pancreatic tail resection for splenic abscess( n = 1),Meckel’s diverticulum resection of ileum( n = 4),gastrojejunostomy for pylorus cicatricial stenosis( n = 2) and esophagogastrostomy for lower esophageal stricture( n = 1). And laparoscopy( n = 114) and traditional open surgery( n = 218) were performed. Results During a follow-up period of 1 month to 4 years,closer-related complications included anastomotic leakage( n = 2),anastomotic stricture( n = 1) and early adhesive intestinal obstruction for biliary atresia( n = 1). Conclusion Using cutting closer is simple,safe and effective for pediatric gastrointestinal surgery so that it is worthy of clinical popularization.更多还原