Dodat H, Chappuis J P, Allantaz F, Daudet M, Morgon A, Pouillaude J M
Chir Pediatr. 1978;19(3):153-61.
The authors report 2 cases of HH and MCT in newborn of 1 1/2 and 5 months old who quickly develop a peptic stenosis despite a good medical treatment. Reviewing 51 cases of early surgical treatment (29 cases operated on before 2 months of age), they estimate legitimal an early surgical treatment for HH and MCT in newborn. They insist on the necessity to begin with a rigourous medical treatment, which cannot exceed one month if an oesophagitis persist (documented by a good and acurate endoscopic examination). This examination is the guide line for the surgical indication and is more acurate than the clinical and radiological informations. They point out the absence of mortality and the improvement of the results if the patients are operated on before 2 months old. In the literature ones can observe that the incidence of recurrence and peptic stenosis is decreased when the patients are operated on early.
作者报告了2例分别为1个半月和5个月大新生儿的肥厚性幽门狭窄(HH)和先天性肥厚性幽门狭窄(MCT)病例,尽管接受了良好的药物治疗,但仍迅速发展为消化性狭窄。回顾51例早期手术治疗病例(29例在2个月龄前接受手术),他们认为对新生儿的HH和MCT进行早期手术治疗是合理的。他们强调必须首先进行严格的药物治疗,如果食管炎持续存在(通过良好且准确的内镜检查证实),药物治疗不能超过1个月。这项检查是手术指征的指导方针,比临床和放射学信息更准确。他们指出,如果患者在2个月龄前接受手术,则无死亡率且结果有所改善。在文献中可以观察到,早期手术治疗的患者复发和消化性狭窄的发生率会降低。