Kramer W L, van der Bilt J D, Bax N M, van der Zee D C
Universitair Medisch Centrum, locatie Wilhelmina Kinderziekenhuis, divisie Heelkunde, afd. Kinderchirurgie, Postbus 85.090, 3508 AB Utrecht.
Ned Tijdschr Geneeskd. 2003 Aug 23;147(34):1646-50.
To evaluate the results of laparoscopic pyloromyotomy in infants with hypertrophic pyloric stenosis (HPS).
Retrospective.
Data from medical records were collected on all children who underwent laparoscopic extramucosal pyloromyotomy for hypertrophic pyloric stenosis in the period from 1 October 1993 to 31 March 2001 in the Wilhelmina Children's Hospital of the Utrecht University Medical Centre, the Netherlands.
A total of 133 children were operated: 108 boys (81%) and 25 girls (19%). The mean age on the day of operation was 35.3 days (SD: 15.4). Of these children, 17 (13%) were ex-prematures and 8 (6%) were ex-dysmatures, and 40 (30%) had a positive family history for HPS. The mean operating time was 29 min (SD: 10); per surgeon, the first 5 operations required over 30 minutes on average and the following operations lasted an average of 26 minutes. Postoperatively, 84 patients (63%) no longer vomited. Four children required a second operation. The mean period from operation to discharge was 61.6 hours (SD: 46.0). Complications included: perforations of the mucosa (n = 4; 3%), wound infections (n = 4; 3%) and small incisional hernias (n = 5; 4%).
Laparoscopic pyloromyotomy is an efficient and safe operative technique for the treatment of infants with HPS.
评估腹腔镜幽门肌切开术治疗肥厚性幽门狭窄（HPS）患儿的效果。
回顾性研究。
收集1993年10月1日至2001年3月31日期间在荷兰乌得勒支大学医学中心威廉明娜儿童医院接受腹腔镜黏膜外幽门肌切开术治疗肥厚性幽门狭窄的所有患儿的病历资料。
共133例患儿接受手术：108例男孩（81%），25例女孩（19%）。手术当天的平均年龄为35.3天（标准差：15.4）。其中，17例（13%）为早产，8例（6%）为过期产，40例（30%）有HPS家族史阳性。平均手术时间为29分钟（标准差：10）；每位外科医生最初的5例手术平均需要30多分钟，随后的手术平均持续26分钟。术后，84例患者（63%）不再呕吐。4例患儿需要二次手术。手术至出院的平均时间为61.6小时（标准差：46.0）。并发症包括：黏膜穿孔（n = 4；3%）、伤口感染（n = 4；3%）和小切口疝（n = 5；4%）。
腹腔镜幽门肌切开术是治疗HPS患儿的一种有效且安全的手术技术。
