Zou Chanjuan,Li Bo,Xiao Yong,et al.Efficacy of laparoscopy versus open surgery for patent omphalomesenteric duct in neonates[J].Journal of Clinical Pediatric Surgery,,22():1034-1038.[doi:10.3760/cma.j.cn101785-202305014-006]
Efficacy of laparoscopy versus open surgery for patent omphalomesenteric duct in neonates
- Abstract:
- Objective To introduce a novel surgical laparoscopic approach for treating patent omphalomesenteric duct (POMD) and compare its efficacy with that of open surgery to understand its advantages.Methods From January 2019 to October 2022,retrospective review was performed for 24 operated POMD children.Based upon different surgical approaches,all eligible children were assigned into two groups of laparoscopy (n=13) and open surgery (n=11).General profiles,clinical manifestations,operative duration,lactation time,hospitalization length and follow-up results of two groups were recorded.Results There were bowel movements and gas discharge from umbilical region (n=12),umbilical mass with recurrent fluid leakage (n=10) and incarcerated intestine (n=2).In laparoscopy group,there were 12 boys and 1 girl with a gestational age at birth 39.4(38.6-40.0) week,an admission age 11.0(7.0-14.5) day and an admission weight 3.5(2.9-3.9) kg.In open surgery group,there were 8 boys and 3 girls with a gestational age at birth 39.8(37.1-40.0) week,an admission age 10.0(6.0-21.0) day and an admission weight 3.3(3.1-3.5) kg.No significant inter-group differences existed in gender,admission weight or age.And gestational age at birth was greater than that of open surgery group (P=0.013).Laparoscopic group had an operative duration of 70.0(51.0-95.0) min and open surgery 64.0(50-70) min.No significant inter-group difference existed in operative duration (P=0.125).Postoperative lactation time was [6.0(5.5-7.0) vs.6.0(6.0-7.0) day].No significant inter-group difference existed (P=0.593).Hospitalization length was 14.0(13.0-16.5) day and open surgery 14.0(13.0-15.0) day.No significant inter-group difference existed (P=0.338).No anastomotic leakage occurred.All of them resumed full feeding and were discharged.During a follow-up period of 12(6-36) months,none became lost.There was no instance of fistula recurrence or re-hospitalization related with surgery.Conclusions Without longer operative duration or more postoperative complications,laparoscopy may preserve the appearance of umbilicus.It is a novel and effective treatment for POMD.
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Memo
收稿日期:2023-5-12。
基金项目:湖南省出生缺陷协同防治科技重大专项(2019SK1015)
通讯作者:周崇高,Email:zhoucg_hnch@163.com