微型腹腔镜幽门环肌切开术182例报告

Mini-laparoscopic pyloromyotomy:a report of 182 cases

目的:总结微型腹腔镜幽门环肌切开术治疗小儿先天性肥厚性幽门狭窄(congenital hypertrophic pyloric stenosis,CHPS)的临床经验,探讨手术成功因素及并发症的防治。方法:回顾分析2001年3月至2009年5月应用微型腹腔镜技术治疗182例CHPS患儿的临床资料,术中分别于左、右、上腹部各穿刺3mm Trocar。结果:180例顺利完成腹腔镜手术,术中2例幽门粘膜损伤中转开腹,术后2例并发脐部戳孔疝经修补治愈;随访至今,无呕吐及肠粘连、肠梗阻等并发症发生。结论:丰富的开腹手术经验、娴熟的腹腔镜技术、专用的腹腔镜器械及固定的手术团队是保障腹腔镜幽门环肌切开术顺利完成的基础。

Objective：To summarize the clinical experience of mini-laparoscopic pyloromyotomy in the treatment of congenital hypertrophic pyloric stenosis（CHPS）,investigate the successful factors of surgery,the prevention and treatment of complications.Methods：The clinical data of 182 CHPS patients who underwent mini-laparoscopic pyloromyotomy from Mar.2001 to May 2009 were retrospectively analyzed.Three 3mm-diameter Trocars were introduced into the abdominal cavity via the left,right and upper abdominal wall,respectively.Results：One hundred and eighty operations were successfully completed,2 cases were converted to open surgery because of mucosal perforations.Two postoperative umbilical port hernias were cured by repairing.No complications such as vomiting,intestinal adhesion and intestinal obstruction were found in the follow-up to today.Conclusions：Laparoscopic pyloromyotomy can be well performed in the presence of experience in open surgery,technical skills in laparoscopy,special laparoscopic instruments and regular surgical team.