Department of Pediatric Surgery, Saitama Medical University, 38 Morohongo, Moroyama-cho, Irumagun, Saitama 350-0495, Japan.
Tokai J Exp Clin Med. 2023 Jul 20;48(2):67-71.
There are several approaches to pyloromyotomy for the treatment of hypertrophic pyloric stenosis including open transumbilical pyloromyotomy and laparoscopic pyloromyotomy. Beginning in 2012, we adopted intraumbilical longitudinal incision as a new transumbilical approach for pyloromyotomy. We describe details of the operative technique and results of this new approach.
We reviewed records of patients undergoing transumbilical pyloromyotomy from 2005 to 2018. Perioperative outcomes were compared between intraumbilical longitudinal incision and supraumbilical incision, the latter of which is the conventional incision for transumbilical pyloromyotomy.
Twenty-four patients underwent pyloromyotomy with intraumbilical longitudinal incision (intraumbilical group) and 28 patients with supraumbilical incision (supraumbilical group). The median operative time was longer in the intraumbilical group (58.0 vs. 43.5 min, p = 0.002). However, the time to full feeding did not differ significantly between the two groups, and the median postoperative stay was shorter in the intraumbilical group (3 vs. 5.5 days, p = 0.003). There was no difference in the rate of complications (4.2% vs. 7.1%, p = 1.0). Scars after intraumbilical longitudinal incision were localized inside the umbilicus.
Pyloromyotomy can be performed through intraumbilical longitudinal incision as safely as supraumbilical incision and intraumbilical longitudinal incision may improve cosmetic results. This approach can be an alternative technique for pyloromyotomy.
治疗肥厚性幽门狭窄有几种幽门肌切开术方法，包括经脐开放幽门肌切开术和腹腔镜幽门肌切开术。自 2012 年以来，我们采用经脐纵向切口作为一种新的经脐幽门肌切开术入路。我们介绍了这种新方法的手术技术细节和结果。
我们回顾了 2005 年至 2018 年期间接受经脐幽门肌切开术的患者记录。比较了经脐纵向切口与上脐切口（经脐传统切口）的围手术期结果。
24 例行经脐纵向切口幽门肌切开术（经脐组），28 例行上脐切口幽门肌切开术（上脐组）。经脐组的手术时间中位数较长（58.0 分钟 vs. 43.5 分钟，p = 0.002）。然而，两组的完全喂养时间无显著差异，经脐组的术后住院时间中位数较短（3 天 vs. 5.5 天，p = 0.003）。两组并发症发生率无差异（4.2% vs. 7.1%，p = 1.0）。经脐纵向切口的疤痕局限于脐内。
经脐纵向切口行幽门肌切开术与上脐切口同样安全，经脐纵向切口可能改善美容效果。这种方法可以作为幽门肌切开术的替代技术。
