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首页> 外文期刊>Surgical Endoscopy >Minimally invasive surgery in infants less than 5 kg: experience of 649 cases.
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Minimally invasive surgery in infants less than 5 kg: experience of 649 cases.

机译：5公斤以下婴儿的微创手术：649例经验。

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INTRODUCTION: With the development of advanced skills and the introduction of miniature laparoscopic tools, endoscopic procedures in infants and small children have become possible. This report documents our experience in minimally invasive surgery (MIS) in infants under 5 kg. METHODS: A retrospective database review was performed from September 1993 to September 2007. All children weighing 5 kg or less that underwent a laparoscopic or thoracoscopic procedure were included. RESULTS: A total of 649 cases were attempted. 43 different procedures were performed, the most common being Nissen fundoplication (310 cases, average operating room (OR) time 43 min, average time to full feeds 2 days), pyloromyotomy (104 cases, average OR time 12.5 min, average hospital days<1), patent ductus arteriosum (PDA) ligation (26 cases, average OR time 31 min, average hospital days<1), tracheoesophageal fistula (TEF) repair (22 cases, average OR time 83 min, average time to full feeds 7.8 days), duodenoduodenostomy (20 cases, average OR time 76 min, average time to full feeds 8.6 days), colonic pull-through for Hirschsprung's disease (18 cases, average OR time 109.6 min, average time to full feeds 3 days), colonic pull-through for imperforate anus (10 cases, average OR time 103 min, average hospital days 2), lung resection (12 cases, average OR time 66.8 min, average hospital days 1.75), congenital diaphragmatic hernia repair (10 cases, average OR time 62.5 min, average time to full feeds 4.75 days). There were no surgery-related deaths. The conversion rate to open was 1.2% (n=8). There were six intraoperative complication rate (0.9%) and the overall complication rate was 3% (20 complications overall). CONCLUSIONS: The development of modern low-flow CO2 insufflators, smaller instruments and telescopes, as well as advanced techniques, has made MIS in neonates feasible and safe. The greatest challenge remains performing intestinal anastomosis in these confined spaces, and further technical advances will be required to make these techniques universally adopted.
机译：简介：随着高级技能的发展和微型腹腔镜工具的推出，婴幼儿内窥镜检查程序已成为可能。本报告记录了我们在5公斤以下婴儿的微创手术（MIS）中的经验。方法：回顾性数据库回顾于1993年9月至2007年9月进行。所有体重在5公斤或以下且接受腹腔镜或胸腔镜手术的儿童均包括在内。结果：共尝试649例。进行了43种不同的程序，最常见的是Nissen胃底折叠术（310例，平均手术室（OR）时间43分钟，平均进食时间为2天），幽门切开术（104例，平均OR时间12.5分钟，平均住院天数< 1），结扎动脉导管未闭（PDA）（26例，平均OR时间31分钟，平均住院天数<1），气管食管瘘（TEF）修复（22例，平均OR时间83分钟，平均满食时间7.8天），十二指肠十二指肠造口术（20例，平均OR时间76分钟，平均全食时间8.6天），结肠穿刺术用于Hirschsprung病（18例，平均OR时间109.6 min，平均全食时间3天） -肛门闭锁（10例，平均OR时间103分钟，平均住院天数2），肺切除术（12例，平均OR时间66.8分钟，平均住院天数1.75），先天性diaphragm肌疝修补术（10例，平均OR时间） 62.5分钟，达到完全喂入的平均时间4.75天）。没有手术相关的死亡。打开的转换率为1.2％（n = 8）。术中并发症发生率为6例（0.9％），总并发症发生率为3％（总共20例并发症）。结论：现代低流量二氧化碳注入器，小型仪器和望远镜以及先进技术的发展使新生儿MIS变得可行和安全。最大的挑战仍然是在这些密闭空间中进行肠吻合，而要使这些技术被普遍采用，还需要进一步的技术进步。

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