Lange R, Rey M, Fernández E Domínguez
Department for Surgery, Ilmtalklinik, Pfaffenhofen, Germany.
Minim Invasive Ther Allied Technol. 2008;17(5):313-7. doi: 10.1080/13645700802274547.
Laparoscopic pyloromyotomy has obtained increasing importance in the last years. However, there is no proof of an obvious advantage of the laparoscopic over the open approach. This retrospective analysis of 157 infants with pyloromyotomies (129 open and 28 laparoscopic procedures) should settle the benefit of one of these procedures. The duration of the operation in the laparoscopic procedure was significantly shorter than in open pyloromyotomy (median 25 versus 34 min; p = 0.025). Complete oral feeding was reached after similar postoperative time in both groups, but the postoperative hospital length of stay in the laparoscopic group was significantly shorter than in the open group (3.5 versus 7 days, p = 0.008). The postoperative requirements for analgetics were low and showed no difference in both groups. In our clinic the laparoscopic pyloromyotomy was successfully introduced as standard operating procedure. There was no difference in the complication rate as compared to the open procedure. The recovery time was shorter in the laparoscopic group. A superiority of the laparoscopic pyloromyotomy over the open procedure is suggested by the ascertained data.
近年来，腹腔镜幽门肌切开术的重要性日益增加。然而，尚无证据表明腹腔镜手术比开放手术具有明显优势。这项对157例行幽门肌切开术的婴儿（129例开放手术和28例腹腔镜手术）的回顾性分析旨在确定这两种手术方法中哪种更具优势。腹腔镜手术的手术时间明显短于开放幽门肌切开术（中位数分别为25分钟和34分钟；p = 0.025）。两组术后达到完全经口喂养的时间相似，但腹腔镜组的术后住院时间明显短于开放组（3.5天对7天，p = 0.008）。两组术后镇痛药的需求量都很低，且无差异。在我们诊所，腹腔镜幽门肌切开术已成功作为标准手术方法引入。与开放手术相比，并发症发生率没有差异。腹腔镜组的恢复时间更短。已确定的数据表明腹腔镜幽门肌切开术优于开放手术。
