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首页> 外文期刊>Surgical Endoscopy >Transumbilical laparoscopically assisted appendectomy in children: The results of a single-port, single-channel procedure
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Transumbilical laparoscopically assisted appendectomy in children: The results of a single-port, single-channel procedure

机译：小儿经脐腹腔镜辅助阑尾切除术：单端口，单通道手术的结果

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Background: Even for pediatric patients, the use of laparoscopic appendectomy has been widely accepted, and three trocars usually are necessary to perform a laparoscopic appendectomy. However, single-port appendectomy for children represents an attractive alternative. To reduce the number of incisions and trocars, the authors have adopted a transumbilical laparoscopically assisted single-port appendectomy (TULAA) approach. This study aimed to evaluate the results of their single-channel, single-port appendectomy. Methods: A retrospective study of TULAA was performed during 12 years with 500 children ages 2-16 years (median, 10.2 years). The TULAA approach is a single-channel surgery using a 12 mm conventional single-port. The vertical incision through the umbilicus is used for laparoscopic access. Two laparoscopic instruments, a 5 mm telescope and a 5 mm grasper, are inserted simultaneously into the single-channel. The grasper holds the base of the appendix, and the appendix is exteriorized through the umbilical incision. Thereafter, a conventional appendectomy is performed extracorporeally. Results: The TULAA procedure was successful for 416 patients (83.2%). These successful TULAA procedures required a mean surgery time of 44.5 min. The pathologic diagnosis of the appendix was acute for 59 patients, phlegmonous for 203 patients, gangrenous for 152 patients, and not detected for two patients. Complications occurred for 47 of these patients (11.3%). Most of the complications were associated with severe intraabdominal inflammation. Two patients needed reoperation under general anesthesia. Conversion to multitrocar surgery or open appendectomy was performed for 84 of the patients (16.8%). Conclusions: The TULAA procedure is a preferable operation for acute appendicitis in children because it is simple and provides good cosmetic results.
机译：背景：即使对于小儿患者，腹腔镜阑尾切除术的使用也已被广泛接受，通常需要三支套管针进行腹腔镜阑尾切除术。但是，儿童单孔阑尾切除术是一种有吸引力的选择。为了减少切口和套管针的数量，作者采用了经脐腹腔镜辅助单端口阑尾切除术（TULAA）的方法。这项研究旨在评估其单通道，单端口阑尾切除术的结果。方法：对500名2-16岁（中位数为10.2岁）的儿童进行12年的TULAA回顾性研究。 TULAA方法是使用12 mm常规单端口的单通道手术。穿过脐带的垂直切口用于腹腔镜检查。同时将两个腹腔镜仪器，5毫米望远镜和5毫米抓取器插入单通道。抓紧器固定阑尾的底部，阑尾通过脐部切口外露。此后，体外进行常规阑尾切除术。结果：TULAA手术成功用于416例患者（83.2％）。这些成功的TULAA手术平均手术时间为44.5分钟。阑尾的病理诊断为急性59例，痰为203例，坏疽为152例，未发现2例。这些患者中有47例发生了并发症（11.3％）。大多数并发症与严重的腹腔内炎症有关。两名患者在全身麻醉下需要再次手术。 84例患者（16.8％）改用了多套管针手术或开放性阑尾切除术。结论：TULAA手术是儿童急性阑尾炎的首选手术方法，因为它简单易行，可提供良好的美容效果。

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