【摘要】 目的探讨腹腔镜手术治疗小儿先天性膈疝的可行性。方法在气管插管全麻下,为患有膈疝的2例新生儿(生后2天、7天)和4例婴幼儿(年龄7~24个月,平均15·5个月)行腹腔镜手术治疗。其中男1例,女5例;左侧膈疝2例,右侧膈疝4例。采用3孔或4孔腹腔镜法,还纳疝内容,丝线缝合膈肌修补缺损。结果4例婴幼儿患儿在腹腔镜下顺利完成手术,手术时间55~180min,平均121min;手术出血量<5ml;无术中并发症;术后1~2天正常活动、进食。术后随访1~2年,术前症状完全消失,无并发症发生。1例新生儿中转开腹手术,另1例新生儿经腹腔镜手术后复发,再经开腹手术治愈。结论腹腔镜手术是治疗婴幼儿膈疝的可行方法,具有显露清楚、损伤小、打击小、切口美观等优点,但对新生儿行该手术仍需进一步探讨。更多还原

【Abstract】 Objective To study the feasibility of laparoscopic repair of congenital diaphragmatic hernia (CDH) in children. Methods Two neonates (age 2 and 7 day) and 4 infants (age 7, 10, 21 and 24 months, averaged 15.5 month), one of them was male, underwent laparoscopic repair of diaphragmatic hernia under general endotracheal anesthesia. Two of them were on the left side, and 4 on the right. 3 or 4 trocars were used. The hernia contents were reduced and the hernia defect was repaired using interrupted sutures. Results The laparoscopic procedures were completed without intra-operative complication in 4 infants. The operating time ranged from 55 to 180 minutes (averaged 121 minutes). Amount of bleeding was less than 5ml. In them full activity and feeding were normal within 1-2 days. 1-2 years follow-up showed no complication or recurrence. In one newborn open abdominal operation was required, and recurrence occurred in the other necessitating re-operation by laparotomy in the other newborn. Conclusions Laparoscopic repair of congenital diaphragmatic hernia in infants is feasible, and its result was satisfactory. The role of laparoscopic correction of diaphragnatic hernia in the newborn period, however, remains to be determined.更多还原