Lu Chaoxiang,Li Peng,Li Mingming,et al.Application of transumbilical single-operator-hole laparoscopic pylorotomy for congenital hypertrophic pyloric stenosis[J].Journal of Clinical Pediatric Surgery,2019,18(03):216-220.[doi:10.3969/j.issn.1671-6353.2019.03.011]
经脐单操作孔腹腔镜技术在先天性肥厚性幽门狭窄中的应用
- Title:
- Application of transumbilical single-operator-hole laparoscopic pylorotomy for congenital hypertrophic pyloric stenosis
- 分类号:
- R729;R656.6+3;R616.5
- 摘要:
- 目的 比较3种手术方式治疗先天性肥厚性幽门狭窄的疗效。方法 回顾性分析2012年9月至2017年6月西安交通大学第二附属医院与西安交通大学附属儿童医院收治的160例先天性肥厚性幽门狭窄患儿临床资料，按照手术方式分为3组：经脐部弧形切口组52例、传统两孔腹腔镜组56例和经脐单操作孔腹腔镜组52例。3组患儿在年龄、体重、术前准备、发病时间、性别比例方面无显著差异（P>0.05）。对比各组患儿在手术时间、出血量、住院时间、足量喂养时间以及切口并发症等资料。结果 经脐部弧形切口组手术时间和术后足量喂养时间均长于腹腔镜组（P<0.05）。3组间出血量差异无统计学意义（P>0.05）。经脐单操作孔腹腔镜组和传统两孔腹腔镜组手术时间、术后足量喂养时间、住院时间差异无统计学意义（P>0.05），但经脐单操作孔组术后切口更加美观。结论 腹腔镜手术与经脐部弧形切口手术相比创伤更小，术后可以更早地进行足量喂养。此外，经脐单操作孔腹腔镜法可以完成腹腔镜下幽门环肌切开术，不增加手术时间及并发症，切口更加美观，值得推广。
- Abstract:
- Objective To explore the advantages and disadvantages of three surgical procedures in the treatment of congenital hypertrophic pyloric stenosis.Methods Retrospective analysis was performed for 160 children with congenital hypertrophic pyloric stenosis from September 2012 to June 2017.Based upon specific surgical procedures,they were divided into three groups of bellybutton arcuate incision (n=52),traditional hole laparoscopy (n=56) and umbilical laparoscopy (n=52).No difference existed in age,weight,preoperative preparation time,time of onset and gender ratio.The data of operative duration,blood loss,hospitalization stay,adequate postoperative feeding time and incision complications were compared for seeking the optimal surgical procedure(P>0.05).There was no difference in the amount of blood loss among three groups(P>0.05).Results No difference existed in operative duration,postoperative feeding time or hospitalization time between single umbilical hole and traditional two-hole laparoscopy groups.However,incision was more aesthetic and invisible in single umbilical hole group.Conclusion Laparoscopy is less invasive than arcuate umbilical incision.Tranumbilical single-operator-hole laparoscopy may accomplish laparoscopic pyloromyotomy without longer operative duration or more complications.With a more aesthetic incision,it is worthy of wider popularization.
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备注/Memo
收稿日期:2018-11-25。
基金项目:国家自然科学基金青年科学基金项目（编号：81701501）
通讯作者:李鹏,Email:1353379997@qq.com