Laparoscopic treatment of intestinal malrotation in children
Laparoscopic treatment of intestinal malrotation in children
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DOI：
10.1007/s004649900848
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发表时间：
1998-11-01
期刊：
影响因子：
--
通讯作者：
van der Zee, DC
中科院分区：
文献类型：
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作者：
Bax, NMA;van der Zee, DC
背景：儿童肠旋转不良的腹腔镜治疗是困难的，我们大多数活跃在腹腔镜外科领域的儿科外科医生同事告诉我们，他们往往必须改用开腹手术。起初，我们也经历了很多困难，但经过改进，我们能够掌握这项技术，现在我们感到有信心。我们在这里描述我们使用的实际技术。方法：我们的经验包括在过去18个月中接受治疗的9名儿童。其中五名儿童在新生儿期出现，四名儿童在之后出现。在腹腔镜手术中，最重要的是不要把注意力集中在十二指肠上，而是要集中在十二指肠上，开始辨认十二指肠，松动十二指肠，直到看到整个小肠，病理解剖容易展开，而且现有的扭转自动减少，肠自动置于腹部不旋转的位置。结果：所有患者手术效果良好，未发现并发症。手术时间减少到约1小时。结论：只要遵循一定的规则，腹腔镜治疗儿童肠旋转不良并不困难。
Background: Laparoscopic treatment of intestinal malrotation in children is difficult, and most of our pediatric surgeon colleagues active in the field of laparoscopic surgery tell us that more often than not they must convert to an open procedure. Initially, we experienced much difficulty too, but after modification we were able to master the technique, and now we feel confident. We here describe the actual technique we use.Methods: Our experience encompasses nine children treated during the past 18 months. Five of the children presented in the newborn period and four later. During laparoscopic surgery, it is of paramount importance to concentrate not on the loops of bowel, but on the duodenum, By starting to identify the duodenum, mobilizing it, and carrying on the mobilization of the small bowel down until the whole small bowel has been seen, the pathologic anatomy is easily unraveled, Moreover, an existing volvulus is automatically reduced and the bowel automatically put in a nonrotation position in the abdomen.Results: All patients have done well, and no complications have been noted. Operative time has been reduced to about 1 hour.Conclusions: Laparoscopic treatment of intestinal malrotation in children is not so difficult provided certain rules, as described, are followed.