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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 저널정보
- 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.97 No.1
- 발행연도
- 2019.7
- 수록면
- 21 - 26 (6page)
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초록· 키워드
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Purpose: Improvements in surgical techniques and a better understanding of the unique anesthetic requirements in neonates undergoing laparoscopy have suggested that laparoscopic surgery may be effective in newborns. This study therefore evaluated the safety and feasibility of laparoscopic excision of the cyst (LEC) in neonates.
Methods: This retrospective study included 43 neonates who underwent excision of choledochal cysts between November, 2001, and January, 2018, including 21 who underwent open excision and 22 who underwent LEC. Their perioperative and surgical outcomes were reviewed. The patients were followed up for a median 37 months (range, 3.141 months).
Results: Baseline characteristics did not differ significantly in the open and LEC groups. Mean intraoperative peak partial pressure of arterial CO₂ (PaCO₂) (45.5 mmHg vs. 48.0 mmHg) and total operation time (208.3 ± 71.0 minutes vs. 235.0 ± 47.2 minutes) were similar in both groups. Parents of the patients in the LEC group provided a more positive evaluation of scar scale and greater satisfaction with wound. No patient in either group experienced any critical complications. Three patients in the open excision group required readmission for cholangitis and 2 patients had ileus. No patient in the laparoscopic excision group experienced any postoperative complications during follow-up.
Conclusion: Despite difficulties performing laparoscopic surgery in neonates, LEC was safe and feasible when intraperitoneal peak pressure was maintained under 10 mmHg and PaCO₂ was closely monitored by a pediatric anesthesiologist. Compared with open excision, LEC provided improved cosmetic outcomes without severe complications. Prospective randomized studies with large numbers of patients are warranted.
Methods: This retrospective study included 43 neonates who underwent excision of choledochal cysts between November, 2001, and January, 2018, including 21 who underwent open excision and 22 who underwent LEC. Their perioperative and surgical outcomes were reviewed. The patients were followed up for a median 37 months (range, 3.141 months).
Results: Baseline characteristics did not differ significantly in the open and LEC groups. Mean intraoperative peak partial pressure of arterial CO₂ (PaCO₂) (45.5 mmHg vs. 48.0 mmHg) and total operation time (208.3 ± 71.0 minutes vs. 235.0 ± 47.2 minutes) were similar in both groups. Parents of the patients in the LEC group provided a more positive evaluation of scar scale and greater satisfaction with wound. No patient in either group experienced any critical complications. Three patients in the open excision group required readmission for cholangitis and 2 patients had ileus. No patient in the laparoscopic excision group experienced any postoperative complications during follow-up.
Conclusion: Despite difficulties performing laparoscopic surgery in neonates, LEC was safe and feasible when intraperitoneal peak pressure was maintained under 10 mmHg and PaCO₂ was closely monitored by a pediatric anesthesiologist. Compared with open excision, LEC provided improved cosmetic outcomes without severe complications. Prospective randomized studies with large numbers of patients are warranted.
목차
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES
참고문헌 (19)
참고문헌 신청
Miyano T / 1996 / Hepaticoenterostomy after excision of choledochal cyst in children : a 30-year experience with 180 cases / J Pediatr Surg 31:1417~1421
Miyano T / 2000 / Congenital biliary dilatation / Semin Pediatr Surg 9:187~195
Ohi R / 1990 / Surgical treatment of congenital dilatation of the bile duct with special reference to late complications after total excisional operation / J Pediatr Surg 25:613~617
Farello GA / 1995 / Congenital choledochal cyst : video-guided laparoscopic treatment / Surg Laparosc Endosc 5:354~358
Li L / 2004 / Laparoscopic-assisted total cyst excision of choledochal cyst and Roux-en-Y hepatoenterostomy / J Pediatr Surg 39:1663~1666
Miyano T / 2000 / Congenital biliary dilatation / Semin Pediatr Surg 9:187~195
Ohi R / 1990 / Surgical treatment of congenital dilatation of the bile duct with special reference to late complications after total excisional operation / J Pediatr Surg 25:613~617
Farello GA / 1995 / Congenital choledochal cyst : video-guided laparoscopic treatment / Surg Laparosc Endosc 5:354~358
Li L / 2004 / Laparoscopic-assisted total cyst excision of choledochal cyst and Roux-en-Y hepatoenterostomy / J Pediatr Surg 39:1663~1666
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UCI(KEPA) : I410-ECN-0101-2019-514-000899703