腹腔镜下小儿阑尾切除术术后残端瘘1例

One Case of Stump Fistula after Laparoscopic Appendectomy in Pediatric

摘要: 目的：探讨腹腔镜下小儿阑尾切除术术后残端瘘的原因和处理方法。方法：研究出现腹腔镜下小儿阑尾切除术术后残端瘘的1例患儿的治疗过程。结果：出现残端瘘的原因可能为线结不牢靠、线结切割残端或电灼残端粘膜时结扎处灼烧坏死。发现残端瘘后行残端修补及肠造瘘术。结论：行腹腔镜下小儿阑尾切除术时残端结扎要确保牢靠，必要时结扎两道。发现残端瘘后要及时做出诊断，如有高热、腹膜炎症状需及时手术处理。

Abstract: Objective: To investigate the causes and treatment of stump fistula after laparoscopic appen- dectomy. Methods: Study the treatment of the case of stump fistula after laparoscopic appen- dectomy. Result: Unreliable knot, cutting effect of suture and ligation of necrotic tissue could be the reasons of stump fistula after laparoscopic appendectomy. Once stump fistula discovered, repair of the stump fistula and enterostomy should be executed. Conclusion: The stump should ba ligated reliable in laparoscopic appendectomy, if necessary, twice ligations are needed. It is necessary to diagnose the stump fistula in time. Emergent surgery is required if high fever or the symptom of peritonitis comes up.