经脐单部位腹腔镜治疗先天性肥厚性幽门狭窄  

Transumbilical Single-site Laparoscopy for Congenital Hypertrophic Pyloric Stenosis

作　　者：孔萌 刘红真 秦虹 夏天 刘威 张士松 Kong Meng;Liu Hongzhen;Qin Hong(Department of General Pediatric Surgery, Qilu Children’s Hospital of Shandong University, Jinan 250022, China)

机构地区：[1]山东大学齐鲁儿童医院普外科,济南250022

出　　处：《中国微创外科杂志》2020年第11期1019-1021,共3页Chinese Journal of Minimally Invasive Surgery

基　　金：山东省济南市卫计委资助项目(2017-2-21)。

摘　　要：目的探讨经脐单部位腹腔镜手术治疗先天性肥厚性幽门狭窄的可行性。方法回顾性分析2018年1~12月经脐单部位腹腔镜治疗先天性肥厚性幽门狭窄43例资料,年龄19~75 d,体重2.9~6.5 kg。脐下缘6点处置3 mm trocar和30°腹腔镜,脐缘3点、9点处各置入3 mm trocar和操作器械(抓钳、幽门刀、分离器或撑开钳),完成幽门环肌切开术。结果43例均顺利完成手术,手术时间20~40 min,平均28 min,无中转开放手术。术后恢复顺利,无并发症发生,术后4~8 d(平均6 d)出院。随访6~18个月,平均12个月,进食正常,未见复发,脐部无可视性瘢痕。结论经脐单部位腹腔镜治疗先天性肥厚性幽门狭窄安全可行,疗效确切,切口美观。Objective To explore the feasibility of transumbilical single-site laparoscopic surgery in treating congenital hypertrophic pyloric stenosis.Methods A retrospective analysis was performed on 43 cases of congenital hypertrophic pyloric stenosis from January 2018 to December 2018.The patients were aged at 19-75 days old and weighted at 2.9-6.5 kg.They were treated by transumbilical single-site laparoscopic surgery.A 3 mm trocar and a 30°laparoscope were inserted at 6 o’clock direction on the lower edge of the umbilicus,and two 3 mm trocars and operating instruments(including grasping forceps,pyloric knife,separator or pliers)were placed at 3 and 9 o’clock on the umbilicus respectively to complete pyloromyotomy.Results The operation was successful in all the 43 cases within 20-40 min(mean,28 min),without conversion to open surgery.The postoperative recovery was smooth without complications,and the patient was discharged at 4-8 days(mean,6 days)after the operation.During follow-ups for 6-18 months(mean,12 months),all the patients recovered well and ate normally without recurrence or visible scar on the umbilical cord.Conclusion Transumbilical single-site laparoscopy for congenital hypertrophic pyloric stenosis is safe and feasible,with definite curative effect and small incision.

关 键 词：单部位腹腔镜手术 幽门狭窄 

分 类 号：R65[医药卫生—外科学]