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目的探讨婴幼儿腹部手术经脐入路这一微创方法的可行性与实用性。方法沿肚脐右侧环形皱襞作半环形切开,最大不超过270°,经腹直肌或中线剪开腹膜,拖出病变或在切口处直视下进行手术操作,可吸收线皮内缝合脐部切口。结果2001年1月~2005年1月,57例患儿经脐行58项手术,手术时间20~170min,无1例需扩大皮肤切口或转为传统开腹术。除术后1例小肠闭锁新生儿出现吻合口瘘,无其他并发症。术后5~7d愈痊出院,随访3月~4年,切口美观,无脐疝发生。结论婴幼儿腹部手术经脐入路安全、简便、微创、美观、实用,适用于多种腹部疾病,在其它手术范围年龄及其他系统疾病都有很好的应用前景。
Objective To investigate the feasibility and practicability of the minimally invasive approach for transurethral approaches to infants undergoing abdominal surgery. Methods The ring along the right side of the navel ring for semi-circular incision, the maximum does not exceed 270 °, cut through the rectus abdominis muscle or midline peritoneum, out of the lesion or under direct incision surgery to absorb the intradermal suture the navel Department incision. Results From January 2001 to January 2005, 58 children underwent 58 operations via the umbilical cord. The operation time ranged from 20 to 170 minutes. No patient needed to enlarge the skin incision or switch to traditional laparotomy. In addition to 1 case of small bowel atresia neonates anastomotic fistula, no other complications. The more recovered after 5 ~ 7d, followed up for 3 months to 4 years, beautiful incision, umbilical hernia occurred. Conclusions Infants’ abdominal surgery is safe, simple, minimally invasive, aesthetic and practical for umbilical access. It is suitable for many kinds of abdominal diseases and has good application prospects in other surgical ranges and other systemic diseases.