腹腔镜下幽门环肌切开术治疗先天性肥厚性幽门狭窄62例

摘要

目的总结腹腔镜下幽门环肌切开术治疗小儿先天性肥厚性幽门狭窄的临床经验，探讨其手术技巧和相关并发症的防治。方法回顾性分析2010年3月至2014年7月本院经腹腔镜行幽门环肌切开治疗的62例先天性肥厚性幽门狭窄患儿临床资料。结果62例中，59例顺利完成手术，术中3例幽门黏膜损伤中转开腹手术，术后1例并发脐部戳孔疝，经修补治愈，1例术后仍有呕吐，行开放手术证实为肌层切开厚度不够所致。所有病例均无呕吐及肠粘连、肠梗阻等并发症发生。结论腹腔镜下行幽门环肌切开术治疗小儿先天性肥厚性幽门狭窄疗效确切，术中损伤小，术后瘢痕小，但需要较高的腹腔镜操作技术。%Objetive To summarize the clinical experience of laparoscopic pyloromyotomy for treatment of congenital hypertrophic pyloric stenosis,and to explore the surgerical skills and prevention of relevant com-plications.Methods Retrospective analysis of clinical data about 62 cases of children with congenital hyper-trophic pyloric stenosis by laparoscopic pyloromyotomy from March ,2010 to July,2014 in our hospital. Re-sults 59 Cases of laparoscopic operation were successfully completed,3 Cases of pyloric mucosa were injured and then operated by laparotomy,postoperative 1 case had umbilical hernia and cured with hole repair,1 case of postoperative was still vomiting,then underwent open operation and confirmed myotomy thickness was not e-nough,all cases have no vomiting and intestinal adhesions,intestinal obstruction and other long-term complica-tions. Conclusion The curative effect of laparoscopic pyloromyotomy for treating congenital hypertrophic py-loric stenosis is reliable,and less surgical trauma,little operation scar,but need higher laparoscopic operation technology.