CAJ | 학술논문

目的：探讨腹腔镜下幽门肌切开术治疗先天性肥厚性幽门狭窄（CHPS）的临床疗效。方法选取2012年5月－2014年3月期间我院共收治的采用腹腔镜下幽门肌切开术治疗36例CHPS 患儿，经脐轮上缘偏右侧的弧形切口，直视下置入一次性利用的5 rnm Trocar，建立气腹，置入30°视镜。在左右上腹部利用11号刀片各戳出一个3 mm 腹壁戳孔，经左侧戳孔直接置入肠钳固定幽门管，右侧戳孔先后直接置入幽门肌切开刀和幽门肌分离钳，完成幽门肌切开术。结果本组36例CHPS 患儿均在腹腔镜下完成手术，无中转开腹，手术时间25～61 min，平均36 min，术后3～6 d 出院。随访3～6个月，生长发育均恢复正常。结论初学腹腔镜下幽门肌切开术，需要一定的知识储备和腹腔镜的手术操作经验，并牢记手术注意事项和技巧。
목적：탐토복강경하유문기절개술치료선천성비후성유문협착（CHPS）적림상료효。방법선취2012년5월－2014년3월기간아원공수치적채용복강경하유문기절개술치료36례CHPS 환인，경제륜상연편우측적호형절구，직시하치입일차성이용적5 rnm Trocar，건립기복，치입30°시경。재좌우상복부이용11호도편각착출일개3 mm 복벽착공，경좌측착공직접치입장겸고정유문관，우측착공선후직접치입유문기절개도화유문기분리겸，완성유문기절개술。결과본조36례CHPS 환인균재복강경하완성수술，무중전개복，수술시간25～61 min，평균36 min，술후3～6 d 출원。수방3～6개월，생장발육균회복정상。결론초학복강경하유문기절개술，수요일정적지식저비화복강경적수술조작경험，병뢰기수술주의사항화기교。
Objective To summarize the beginners′experience of laparoscopic pyloromyotomy for congenital hypertrophic pyloric stenosis (CHPS).Methods Selecting 36 cases of children with CHPS were treated by laparoscopic pylorus myotomy treated in our hospital during May 2012 to Mar.2014,A 5 mm trocar through a incision at the higher border of the umbilical ring was placed under direct vision for the insertion of camera.Two 3 mm working instruments were inserted directly into the abdomen via separate lateral incisions.A intestinal clamp was inserted through the left incision to manipulate the gastric wall near the pylorus.Through the right incision,a retractable pyloromyotomy scalpel and a dissecting forceps were in turn utilized to complete pyloromyotomy.Results The pyloromyotomy was completed successfully under laparoscope in all 36 cases,with an operation time of 25-61 min (mean 36 min),without a conversion to open surgery.The patients were discharged at 3-6 postoperative days.All discharged patients were followed up for 3-6 months and normally developed.Conclusion The knowledge reserve,precautions and technical skills of laparoscopic pyloromyotomy for infants with CHPS were need for beginners.