Collins J B, Georgeson K E, Vicente Y, Hardin W D
University of Alabama at Birmingham, USA.
J Pediatr Surg. 1995 Jul;30(7):1065-70; discussion 1070-1. doi: 10.1016/0022-3468(95)90343-7.
The rapid development and incorporation of minimally invasive surgical techniques has abruptly changed adult surgical practices. These minimally invasive procedures are now being successfully applied to pediatric surgical problems. The anticipated benefits of these techniques include less postoperative pain, quicker return of bowel function, shorter hospital stay, and lower hospital costs, with a quicker return to normal activity. This report compares the first 60 infants and children to undergo laparoscopic gastrostomy and/or fundoplication at our institution with the same number of patients that underwent these procedures in the traditional open fashion. The two groups were similar with respect to age, sex, concurrent illness, presenting symptoms, neurological status, and procedures performed. Patients in the laparoscopic group were found to have shorter mean hospital and postoperative stays and tolerated feeding earlier. The mean hospital stay was 13.8 days for the laparoscopic group versus 16.4 days in the open group. The mean postoperative stay was 6.8 days for the laparoscopic group versus 10.7 days for the open group. The mean postoperative day on which feeding was tolerated was 2.3 in the laparoscopic group versus 4.8 in the open group. Postoperative complications were similar between the two groups. These results seem to reflect the less traumatic nature of the laparoscopic procedures as compared with the open procedures. Laparoscopic fundoplication and gastrostomy is an attractive alternative to open fundoplication and gastrostomy in infants and children.
微创外科技术的迅速发展与应用，彻底改变了成人外科手术的操作方式。如今，这些微创操作已成功应用于小儿外科问题。这些技术预期的益处包括术后疼痛减轻、肠功能恢复更快、住院时间缩短、住院费用降低，以及能更快恢复正常活动。本报告将我院首批60例接受腹腔镜胃造口术和/或胃底折叠术的婴幼儿与同等数量以传统开放方式进行这些手术的患者进行了比较。两组在年龄、性别、并发疾病、症状表现、神经状态及所施行的手术方面相似。结果发现，腹腔镜组患者的平均住院时间和术后住院时间更短，且更早耐受喂养。腹腔镜组的平均住院时间为13.8天，而开放组为16.4天。腹腔镜组的平均术后住院时间为6.8天，开放组为10.7天。腹腔镜组耐受喂养的平均术后天数为2.3天，开放组为4.8天。两组术后并发症相似。这些结果似乎反映出与开放手术相比，腹腔镜手术创伤性更小。对于婴幼儿而言，腹腔镜胃底折叠术和胃造口术是开放胃底折叠术和胃造口术颇具吸引力的替代选择。
