腹腔镜与开腹手术治疗先天性肥厚性幽门狭窄的比较

Recovery after open versus laparoscopic pyloromyotomy for pyloric stenosis

目的 比较腹腔镜与常规开腹手术治疗先天性肥厚性幽门狭窄的疗效.方法 2008年3月至2011年10月,我们分别应用腹腔镜及常规开腹手术治疗先天性肥厚性幽门狭窄163例,从手术时间、术后呕吐、并发症等方面比较两种手术的优缺点.结果 87例行常规开腹手术,76例行腹腔镜手术.两种手术方法在术后呕吐次数、手术时间、术后并发症上比较,差异无统计学意义.腹腔镜组有2例穿孔,术中中转开腹行修补术.术后呕吐与体重及年龄比较,差异有统计学意义（P＜0.01）.结论 腹腔镜及常规开腹手术均是治疗先天性肥厚性幽门狭窄的安全可靠的治疗方法,腹腔镜手术具有损伤小、伤口美观等优点.

Objetive To compare outcomes after open or laparoscopic pyloromyotomy for the treatment of pyloric stenosis ; Methods We reviewed the records of 163 patients who underwent pyloromyotomy at our institution between March, 2008, and October 2011, data were collected regarding operative time, time to full feeds, complications, and frequency of postoperative emesis; Results There were 76 laparoscopic and 87 open. There were no significant differences in frequency of postoperative emesis and operative time, The overall complication rate was similar （LP,3.7% ; OP,3.2% ） ;Convertion to an open procedure was done in two pa- tients in the laparoscopic group . Age and body weight were related to persisted postoperative emesis （P 〈 0. 01 ） ; Conclusions Both open and laparoscopic pyloromyotomy are safe procedures for the management of pyloric stenosis. However, laparoscopy has advantages for minor injuries and better cosmesis.