经脐途径腹腔内幽门肌切开术：一项技术改进
Intraabdominal pyloromyotomy through the umbilical route: a technical improvement.
作者信息
De Caluwe D, Reding R, de Ville de Goyet J, Otte J B
机构信息
Pediatric Surgery Unit, St-Luc University Clinics, University of Louvain Medical School, Brussels, Belgium.
出版信息
J Pediatr Surg. 1998 Dec;33(12):1806-7. doi: 10.1016/s0022-3468(98)90290-1.
BACKGROUND/PURPOSE: Performing a pyloromyotomy through a supraumbilical skin fold incision will leave an almost invisible scar and therefore has definitive cosmetic advantages. This alternative approach may be related to technical difficulties in delivering a large pyloric tumor when compared with the conventional pyloromyotomy through a right upper quadrant incision. However, in situ (intraabdominal) myotomy can help overcome this inconvenience.
METHODS
Of 122 cases of infantile hypertrophic pyloric stenosis operated on between January 1990 and August 1996, 29 underwent a pyloromyotomy performed intraabdominally through the umbilical route. The medical records of these babies were reviewed.
RESULTS
Twenty-three boys and six girls (median age, 30 days; range, 17 to 70 days) underwent surgery. The median hospital stay was 2.5 days. There were two intraoperative technical complications (small mucosal perforation) and one postoperative wound complication (abcess formation) requiring local drainage.
CONCLUSIONS
In situ pyloromyotomy through the umbilical route is an elegant alternative in cases of a large pyloric tumor.
背景/目的：经脐上皮肤褶皱切口行幽门肌切开术会留下几乎不可见的瘢痕，因此具有明显的美容优势。与经右上腹切口行传统幽门肌切开术相比，这种替代方法可能在处理较大的幽门肿瘤时存在技术困难。然而，原位（腹腔内）肌切开术有助于克服这一不便。
方法
在1990年1月至1996年8月间接受手术的122例婴儿肥厚性幽门狭窄病例中，29例经脐途径在腹腔内行幽门肌切开术。回顾了这些婴儿的病历。
结果
23例男孩和6例女孩（中位年龄30天；范围17至70天）接受了手术。中位住院时间为2.5天。有2例术中技术并发症（小的黏膜穿孔）和1例术后伤口并发症（脓肿形成），后者需要局部引流。
结论
对于较大的幽门肿瘤病例，经脐途径原位幽门肌切开术是一种不错的替代方法。
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