Wang Dafeng,Cai Yijin,Gu Hao,et al.Efficacy comparison of single-site laparoscopy through umbilical margin incision versus three-port laparoscopy for congenital hypertrophic pyloric stenosis[J].Journal of Clinical Pediatric Surgery,2026,(01):59-63.[doi:10.3760/cma.j.cn101785-202410035]
经脐缘切口单部位腹腔镜与三孔腹腔镜在先天性肥厚性幽门狭窄治疗中的效果比较
- Title:
- Efficacy comparison of single-site laparoscopy through umbilical margin incision versus three-port laparoscopy for congenital hypertrophic pyloric stenosis
- Keywords:
- Laparoscope; Pyloric Stenosis; Hypertrophic; Surgical Procedures; Operative; Child
- 摘要:
- 目的 比较经脐缘切口单部位腹腔镜与三孔腹腔镜在先天性肥厚性幽门狭窄治疗中的临床效果。方法 回顾性分析2018年5月至2024年5月期间,无锡市儿童医院收治的65例先天性肥厚性幽门狭窄患儿临床资料。根据手术方式分为单孔组(28例)和三孔组(37例)。收集并比较两组患儿的一般资料、术中及术后临床资料以及术后随访情况。结果 单孔组与三孔组患儿在年龄[(44.64±9.01)d比(45.76±9.19)d]、体质量[(3.97±0.38)kg比(4.07±0.44)kg]、性别等一般资料上差异无统计学意义(P＞0.05)。两组手术时间[(36.82±8.33) min比(39.92±6.85) min]、术中中转情况(0/28比1/37)、术中黏膜破损(0/28比1/37)、恢复喂养时间[(13.04±2.55)h比(13.60±2.61)h]、自主排便时间[(22.32±6.20)h比(23.46±4.82)h]、术后住院时间[(7.29±1.58)d比(7.51±1.52)d]、术后呕吐(1/28比3/37)、伤口感染(1/28比2/37)、伤口裂开(0/28比1/37)等情况比较,差异无统计学意义(P>0.05)。术后随访期间,单孔组的切口美观度评分优于三孔组[(1.57±0.63)分比(4.03±0.37)分],差异有统计学意义(P<0.001)。结论 经脐缘切口单部位腹腔镜与三孔腹腔镜在治疗先天性肥厚性幽门狭窄中均显示出良好的安全性、有效性,但经脐缘切口单部位腹腔镜在术后切口美观度上更有优势。
- Abstract:
- Objective To compare the clinical efficacies of single-site laparoscopy through umbilical margin incision versus three-port laparoscopy for congenital hypertrophic pyloric stenosis (CHPS). Methods A retrospective analysis was conducted for the relevant clinical data of 65 CHPS children admitted into Wuxi Children’s Hospital from May 2018 to May 2024.According to specific surgical approaches,they were assigned into two groups of single-port (n=28) and three-port (n=37).General profiles,perioperative clinical data,and postoperative follow-up status of two groups were compared. Results No statistically significant inter-group differences existed in general profiles,including age[(44.64±9.01) vs.(45.76±9.19) day],body weight[(3.97±0.38) vs.(4.07±0.44) kg]or gender.No statistically significant inter-group differences existed in operative duration[(36.82±8.33) vs.(39.92±6.85) min],intraoperative conversion (0/28 vs.1/37),intraoperative mucosal injury (0/28 vs.1/37),time to resuming feeding[(13.04±2.55) vs.(13.60±2.61) h],time to initial bowel movement[(22.32±6.20) vs.(23.46±4.82) h],postoperative hospitalization stay[(7.29±1.58) vs.(7.51±1.52) day],postoperative vomiting (1/28 vs.3/37),wound infection (1/28 vs.2/37) or wound dehiscence (0/28 vs.1/37) (P>0.05).During postoperative follow-ups,cosmetic score of incision was significantly superior in single-port group than that in three-port group[(1.57±0.63) vs.(4.03±0.37)]with a statistically significant difference (P<0.001). Conclusions Both single-site laparoscopy through umbilical margin incision and three-port laparoscopy have demonstrated excellent safety and effectiveness for CHPS.However,the former offers advantages in postoperative incision aesthetics.
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备注/Memo
收稿日期:2024-10-15。
基金项目:国家自然科学基金(82101339);江苏省自然科学基金(BK20221205);无锡市卫生健康委青年项目(Q202534)
通讯作者:蔡义进,Email:cayijin512@163.com