Song Aohua, Xiang Xiao, Zhang Bobin, Li Xunfeng, Guo Zhenhua
Department of Neonatal Surgery, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development, Chongqing Key Laboratory of Structural Birth Defect and Reconstruction, Chongqing, PR China.
Department of Neonatal Surgery, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development, Chongqing Key Laboratory of Structural Birth Defect and Reconstruction, Chongqing, PR China.
J Pediatr Surg. 2025 Mar;60(3):162113. doi: 10.1016/j.jpedsurg.2024.162113. Epub 2024 Dec 28.
This study sought to assess the advantages of utilizing the single-incision laparoscopic surgery (SILS) procedure for repairing neonatal congenital duodenal obstruction (CDO) in terms of clinical outcomes and complication rates.
In a retrospective cohort study conducted at a single center, neonates with CDO who underwent SILS were compared to those who underwent conventional laparoscopic surgery (CLS) between January 2018 and December 2022. The demographic and operative characteristics of CDO patients who underwent SILS or CLS were analyzed, including conversion rates and postoperative complications.
Of these, 75 patients were assigned to the CLS group, while 55 patients belonged to the SILS group. No statistically significant differences were detected between the two groups in terms of baseline characteristics. The median operative time was significantly longer in the SILS group than in the CLS group (130 min vs. 120 min, P = 0.02). The SILS group experienced a longer delay in the initiation of feeds than did the CLS group (5 days vs. 4 days, p = 0.001); however, there was no statistically significant difference in the time to reach full feeds between the two groups (9 days vs. 9 days, p = 0.07). In the SILS group, the incidences of incisional hernia and infection were higher than those in the CLS group, but the differences were not statistically significant (9.09 % vs. 4.00 %, P = 0.41 & 10.91 % vs. 5.33 %, P = 0.39). There were no statistically significant differences in the incidences of anastomotic stricture/leakage, adhesive intestinal obstruction, or missed diagnosis related to malformation between the two groups. The incidence of conversion to laparotomy was found to be 6.67 % and 9.09 % in the respective groups, with no statistically significant difference detected.
The efficacy and safety of the SILS procedure for neonatal CDO repair are comparable to those of the CLA procedure, and the SILS procedure has potential cosmetic advantages.
本研究旨在从临床结局和并发症发生率方面评估单切口腹腔镜手术（SILS）修复新生儿先天性十二指肠梗阻（CDO）的优势。
在一个单一中心进行的回顾性队列研究中，将2018年1月至2022年12月期间接受SILS的CDO新生儿与接受传统腹腔镜手术（CLS）的新生儿进行比较。分析接受SILS或CLS的CDO患者的人口统计学和手术特征，包括中转率和术后并发症。
其中，75例患者被分配到CLS组，55例患者属于SILS组。两组在基线特征方面未检测到统计学上的显著差异。SILS组的中位手术时间明显长于CLS组（130分钟对120分钟，P = 0.02）。SILS组开始喂养的延迟时间比CLS组长（5天对4天，p = 0.001）；然而，两组达到全量喂养的时间没有统计学上的显著差异（9天对9天，p = 0.07）。在SILS组中，切口疝和感染的发生率高于CLS组，但差异无统计学意义（9.09%对4.00%，P = 0.41 & 10.91%对5.33%，P = 0.39）。两组在吻合口狭窄/渗漏、粘连性肠梗阻或与畸形相关的漏诊发生率方面没有统计学上的显著差异。发现中转开腹的发生率在各自组中分别为6.67%和9.09%，未检测到统计学上的显著差异。
SILS手术修复新生儿CDO的疗效和安全性与CLS手术相当，并且SILS手术具有潜在的美容优势。
