Lü Chengjie,Hu Shuqi,Chen Rui,et al.Clinical exploration of ambulatory surgery mode of infantile hypertrophic pyloric stenosis[J].Journal of Clinical Pediatric Surgery,,21():258-264.[doi:10.3760/cma.j.cn101785-202106073-011]
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Clinical exploration of ambulatory surgery mode of infantile hypertrophic pyloric stenosis

Journal of Clinical Pediatric Surgery[ISSN:1671-6353/CN:43-1380/R] volume: 第21卷 Number: 2022 03 Page: 258-264 Column: 论著 Date of publication: 2022-03-28
Author(s):
Lü Chengjie1;  Hu Shuqi1;  Chen Rui1;  Wang Peng1;  Ma Dong1;  Zhao Xiaoxia1;  Han Yijiang1;  Lai Dengming1;  Qin Qi1;  Tou Jinfa1;  Liang Jianfeng2</
1 National Clinical Research Center for Child Health;Department of Neonatal Surgery, Children’s Hospital, Zhejiang University School of Medicine, Hangzhou 310052, China;
2 National Clinical Research Center for Child Health;Ambulatory surgery center, Children’s Hospital, Zhejiang University School of Medicine, Hangzhou 310052, China
Keywords:
Pyloric Stenosis;  Hypertrophic/CN; Pyloric Stenosis;  Hypertrophic/SU; Surgical Procedures;  Operative/MT; Enhanced Recovery After Surgery; Ambulatory Surgery
DOI:
10.3760/cma.j.cn101785-202106073-011
Abstract:
Objective To explore the mode and feasibility of ambulatory surgery (AS) for infantile hypertrophic pyloric stenosis (IHPS) during enhanced recovery after surgery (ERAS).Methods Retrospective analysis was performed for clinical data of 163 children hospitalized with infantile hypertrophic pyloric stenosis from January 2018 to December 2020.ERAS management model was adopted during perioperative period of IHPS since January 2018 and AS for IHPS since September 2019.Children admitted before September 2019 were designated as ERAS group and those after as ERAS+AS group.And children in ERAS group fulfilling the ambulatory surgery admission and discharge standards simultaneously at 15h post-operation were recorded as ERAS1 group and the remainders as ERAS2 group; Children in ERAS+AS group not completing ambulatory surgery mode were recorded as ERAS+AS 1 group while those not completing ambulatory surgery mode as ERAS+AS 2 group.The treatment-related clinical parameters and hospitalization expenses were recorded for exploring the feasibility of IHPS ambulatory surgery admission standards and models.Results All of them successfully completed transumbilical single-site laparoscopic pyloric myotomy.There was no conversion into laparotomy.Pyloric duct perforation was absent.Comparison of ERAS+AS 1 group and ERAS+AS 2 group, operative age[(43.77±15.16) vs.(36.93±22.42) days], pre-admission course of disease[(15.59±12.73) vs.(14.00±12.76) days] and frequency of vomiting within 1 week post-operation[(2.18±0.50) vs.(2.49±0.59)].There was no significant inter-group difference (P>0.05); preoperative length of hospital stay[(11.64±8.40) vs.(52.07±31.40) hours], postoperative hospital stay[(18.16±3.86) vs.(77.81±42.28) hours] and hospitalization expense[(8 474.16±537.73) vs.(12 413.61±3 341.96) yuan].The inter-group differences were statistically significant(P<0.05); length of stay and hospitalization expense in day-to-day surgery group were significantly lower than those in incomplete group.Comparing ERAS+AS 1 and ERAS 1 groups, frequency of vomiting within 1 week post-operation was[(2.18±0.50) vs.(2.29±0.60)].There was no significant inter-group difference (P>0.05); preoperative length of hospitalization[(11.64±8.40) vs.(42.00±16.85) hours], postoperative hospital stay[(18.16±3.86) vs.(74.66±14.02) hours] and hospitalization expense[(8 474.16±537.73) vs.(12 891.76±3 181.31) yuan].And inter-group difference was statistically significant (P<0.05).Conclusion Under the premise of mastering the admission standards of ambulatory surgery, AS for IHPS is both feasible and safe.It is worthy of further researches and explorations.

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Memo

收稿日期:2021-06-29。
基金项目:国家中心自主设计项目（R22G0014）
通讯作者:黄寿奖,Email:huangshoujiang@zju.edu.cn

Last Update: 1900-01-01