| PurposeCompare the advantages and disadvantages of complete laparoscopy and traditional laparotomy in the treatment of children with small intestinal malformations(Michael's diverticulum and intestinal duplication),To investigate the feasibility and safety of complete laparoscopy in the treatment of children with small intestinal malformations(Michael's diverticulum and intestinal duplication).Materials and methodsThe clinical data of 31 cases of pediatric Michael's diverticulum or intestinal duplication treated by surgery in the third affiliated hospital of zhengzhou university from January 2016 to November 2018 were retrospectively analyzed.The basic situation,clinical situation,preoperative auxiliary examination,operation date,operation time,intraoperative situation and postoperative recovery were recorded.Total laparoscopic surgery was performed in 15 cases,including 6 males and 9 females,aged from 4 months to 10 years and 5 months,with a median age of 3 years.Weight 7.4 ~ 33.0 kg,median weight 16.0 kg.16 cases were treated by traditional surgery,including 10 males and 6 females,aged from 33 days to 11 years old,median age 7.5 months.Weight: 5 ~ 38 kg,median weight: 8 kg.Among the 31 children in this group,5 were admitted with painless hematochezia,12 with abdominal pain and vomiting,3 with abdominal mass,6 with intestinal abnormalities found in prenatal examination,1 with umbilical fluid leakage,and 4 with previous history of intussusception or intussusception.Preoperative HGB 61-133 g/L,including 7 cases of 60 ~ 75 g/L,was corrected to the normal range by transfusion of homotypic suspension red blood cells.The operative time,intraoperative blood loss,postoperative feeding time,postoperative hospitalization time,and postoperative complications of the two surgical methods were compared.SPSS 21.0 statistical software was used for statistical analysis.Measurement data of normal distribution were expressed as x s,and t test of two independent samples was used for comparison between groups.P<0.05 was considered statistically significant,while P<0.01 was considered very significant.ResultAmong the 31 children(14 cases of meckel diverticulum and 17 cases of intestinal duplication),15 patients completed the operation under complete laparoscopy without conversion to laparotomy,and the operation time was 62.73±22.61 min.The average operation time of traditional laparotomy was 57.50±12.40 min,and there was no statistical difference between the two(P>0.05).There was no significant difference between the total laparoscopic operation time and the traditional operation time.The patients in the complete laparoscopic group received the recovery diet at 4.67±1.40 days after surgery,while the children in the traditional laparotomy group received the recovery diet at 5.75 ±1.07 days after surgery,and There was a statistically significant difference between the two groups(P<0.05).The total laparoscopic group had shorter recovery time than the traditional group.The postoperative hospitalization time of the complete laparoscopic group was 10.47± 1.85 d,and that of the traditional laparoscopic group was 13.69± 4.00 d,the difference was statistically significant(P<0.05).The total laparoscopy group was better than the traditional laparotomy group.There was no significant difference in intraoperative blood loss between the two groups(P>0.05).No anastomotic stenosis,intestinal leakage,adhesion ileus or other complications occurred in the two groups after 3-24 months of follow-up.ConclusionComplete laparoscopy is safe and feasible for the treatment of children's small intestinal malformations(Michael's diverticulum or intestinal duplication)with the advantages of minimally invasive,quick recovery,less complications and less scar. |
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