Hu Shuqi,LYU Chengjie,Han Yijiang,et al.Application of laparoscopic technique for duodenal obstruction in neonates with different birth weights[J].Journal of Clinical Pediatric Surgery,,19():800-805.[doi:10.3969/j.issn.1671-6353.2020.09.008]
Application of laparoscopic technique for duodenal obstruction in neonates with different birth weights
- Keywords:
- Duodenal Obstruction/SU; Laparoscopy; Treatment Outcome; Infant; Newborn
- CLC:
- R722.1;R616.5
- Abstract:
- Objective To provide more clinical rationales for the safety and feasibility of laparoscopy by comparing the corresponding data for neonatal duodenal obstruction with different birth weights. Methods A retrospective analysis was performed for 42 neonates undergoing laparoscopy for duodenal obstruction from June 2017 to June 2019.For normal birth weight,low birth weight and very low birth weight infant groups,blood gas profiles before and after pneumoperitoneum were monitored.And surgical related parameters (e.g.intraoperative changes of body temperature,fluctuation range of body temperature,bleeding volume,operative duration & postoperative tracheal intubation) were recorded. Results The clinical data were summarized for 42 neonates undergoing laparoscopy for duodenal obstruction.There were 16 cases (4 boys and 12 girls) of low birth weight,6 cases (4 boys and 2 girls) of very low birth weight and 20 cases (10 boys and 10 girls) of normal birth weight.Comparing three groups,intraoperative volume of blood loss (F=0.1,P=0.905),operative duration (F=0.636,P=0.535),extubation Time (F=1.244,P=0.299) or intraoperative temperature (F=1.303,P=0.283) had no statistically significant difference; bleeding volume or birth weight (F=5.681,P=0.007),time from initial feeding to full feeding (F=11.638,P<0.001) and intraoperative temperature fluctuations (F=18.09,P<0.001) were statistically significant.Blood gas analysis indicated that the values of pH,PaCO2,PaO2,SO2,HCO3- and SBE all changed before and after establishing CO2 pneumoperitoneum.After pneumoperitoneum,pH value decreased,PaCO2 increased and the change trend remained consistent. Conclusion The application of laparoscopy is both safe and feasible for duodenal obstruction of newborns with different birth weights.During operation,surgeons should pay more attention to volume of blood loss,strengthen the monitoring of body temperature and monitor the change of blood gas during CO2 pneumoperitoneum.
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Memo
收稿日期:2020-02-12。
基金项目:国家自然科学基金资助项目（编号：81901989）；中国博士后科学基金资助项目（编号：2019M652108）
通讯作者:黄寿奖,Email:huangshoujiang@zju.edu.cn