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目的探讨在腹腔镜辅助下,结合术中冰冻,基底部结扎法切除儿童美克尔憩室的临床效果及优势。方法对43例美克尔憩室患儿采取单纯基底部结扎法切除美克尔憩室,行术中冰冻病理检查,判断基底部是否残留异位粘膜组织,再决定是否结束手术或行锲行肠切除或肠切除术。结果 43例患儿均顺利完成手术,4例因基底部残留异位粘膜组织,遂行锲行切除或肠切除术,其余所有病例术中冰冻均未见残留异位粘膜,于基底部结扎后结束手术。术后随访6个月至7年,所有患儿均未见再次便血、肠瘘等并发症。结论采用术中冰冻病理检查,可以很好的判断基底部是否残留美克尔憩室异位粘膜,而行基底部结扎是安全有效的全新手术方式,可以明显缩短手术时间,缩短术后禁食的时间。
Objective To investigate the clinical effects and advantages of laparoscopic assisted resection of children’s merkel diverticulum combined with intraoperative freezing and basal ligation. Methods Forty-three cases of Meckel’s diverticulum were treated with simple basilar ligation to remove Meckel’s diverticulum. The intraoperative frozen pathological examination was performed to determine whether residual ectopic mucosa remained in the basal part, Or bowel resection. Results All the 43 children underwent surgery successfully. Four cases had residual ectopic mucosa at the basal part, followed by wedge or intestine resection. No residual ectopic mucosa was found in all other cases, surgery. All patients were followed up for 6 months to 7 years. No complication of blood in the stool and intestinal fistula occurred again. Conclusion Intraoperative frozen pathological examination can be a good judge of residual methicillin remover ectopic mucosa, while the base of the ligation is a safe and effective new surgical approach, can significantly reduce the operation time and shorten the postoperative fasting time .