Xiao SJ,Yang WY,Zhu XC,et al. Analysis of laparoscopic diagnosis and treatment for 54 neonates with congenital duodenal obstruction.[J].Journal of Clinical Pediatric Surgery,,18():141-146.
Analysis of laparoscopic diagnosis and treatment for 54 neonates with congenital duodenal obstruction.
Journal of Clinical Pediatric Surgery[ISSN:1671-6353/CN:43-1380/R]
volume:
第18卷
Number:
2019 02
Page:
141-146
Column:
论著
Date of publication:
2019-02-25
- Keywords:
- ; Duodenal Obstruction; Laparoscopes; Diagnosis; Therapy; Neonate
- Document code:
- A
- Abstract:
- ObjectiveTo summarize etiological diagnosis and laparoscopic surgery of congenital duodenal obstruction in neonates.MethodsRetrospective data analysis was performed for 54 neonates with congenital duodenal obstruction from January 2017 to March 2018.A preoperative etiological diagnosis was made by prenatal ultrasound,upper gastrointestinal angiography and gastroduodenal ultrasound examination.Then laparoscopic exploration were performed for excluding duodenal obstruction with multiple sites and causes.Laparoscopic Ladds procedure,duodenum diaphragm excision & transverse suture or duodenal diamond anastomosis were performed according to the specific pathogenesis.A gastrointestinal nutrition tube were placed via nose into jejunum with laparoscopic pliers for early feeding.ResultsPreoperative ultrasound indicated congenital intestinal malrotation (n=23),duodenal diaphragm (n=6),duodenal atresia/stenosis (n=10),annular pancreas (n=13) and duodenal atresia/stenosis accompanied with duodenal diaphragm (n=2).Except for 2 cases of duodenal atresia/stenosis plus duodenal diaphragm,the above etiological diagnosis was confirmed by laparoscopy.And the diagnostic accordance rate of preoperative etiology was 96.3%.All operations were completed with laparoscopy without any conversion into laparotomy or intraoperative complications.The mean operative duration was (123.8±53.9)(50-280) min.And the mean time of initial oral feeding,postoperative adequate food intake and hospitalization length was (8.9±3.4)(5-23),(12.1±4.5)(7-26) and (16.7±7.4)(8-57) days respectively.There was no onset of such postoperative complications as anastomotic fistula/obstruction or venous nutritionrelated complications.Except for 3 cases,intestinal torsion and intestinal adhesion occurred after surgery.Postoperative followups showed no duodenum obstruction and feeding was fine.There was no vomiting and wound healing was excellent.ConclusionPreoperative ultrasound may reach an etiological diagnosis of neonatal congenital duodenal obstruction.Laparoscope can detect and handle multiple duodenal obstructions at the same time.With the advantages of safety,minimal trauma,early food intake,quick recovery and excellent cosmetics effect,it is also ideal for lowweight and premature infants.
Last Update:
2019-02-26