CAJ | 학술논문

目的：探讨经脐单一部位腹腔镜下幽门环肌切开术治疗小儿先天性肥厚性幽门狭窄（ congenital hypertrophic pyloric stenosis， CHPS）的临床疗效。方法2012年8月～2013年12月，我科应用腹腔镜经脐单一部位行幽门环肌切开术治疗小儿先天性肥厚性幽门狭窄30例。术中在脐部置入5 mm trocar，放置腹腔镜，在脐环皱褶旁右侧放置2个3 mm trocar，先后置入电钩、抓钳和幽门分离器，完成幽门环肌切开术。结果30例手术顺利完成，无中转开腹。手术时间25～55 min，（35．9±12．1）min。无并发症发生。术后6 h拔除胃管，从喂糖水逐渐过渡至喂奶。术后住院3～6 d，（3．8±1．1）d。切口隐蔽且美观。30例术后随访3～6个月，生长发育均恢复正常，脐部外观美观，几乎无法观察到手术瘢痕。结论经脐一单部位腹腔镜下幽门环肌切开术治疗小儿先天性肥厚性幽门狭窄安全可靠，疗效满意，切口隐蔽且美观。
목적：탐토경제단일부위복강경하유문배기절개술치료소인선천성비후성유문협착（ congenital hypertrophic pyloric stenosis， CHPS）적림상료효。방법2012년8월～2013년12월，아과응용복강경경제단일부위행유문배기절개술치료소인선천성비후성유문협착30례。술중재제부치입5 mm trocar，방치복강경，재제배추습방우측방치2개3 mm trocar，선후치입전구、조겸화유문분리기，완성유문배기절개술。결과30례수술순리완성，무중전개복。수술시간25～55 min，（35．9±12．1）min。무병발증발생。술후6 h발제위관，종위당수축점과도지위내。술후주원3～6 d，（3．8±1．1）d。절구은폐차미관。30례술후수방3～6개월，생장발육균회복정상，제부외관미관，궤호무법관찰도수술반흔。결론경제일단부위복강경하유문배기절개술치료소인선천성비후성유문협착안전가고，료효만의，절구은폐차미관。
Objective To investigate the clinical efficacy of transumbilical single-site laparoscopic pyloromyotomy for treating congenital hypertrophic pyloric stenosis ( CHPS). Methods From August 2012 to December 2013, transumbilical single-site laparoscopic pyloromyotomy was applied in 30 cases of CHPS .The procedure was performed by using a 5 mm trocar in the navel for the laparoscope and two 3 mm trocars in the right side of umbilical ring crease .Through these 3 mm trocars, a hook electrode, a non-traumatic grasping forceps , and a dissecting forceps were in turn utilized to carry out pyloromyotomy . Results All the 30 patients underwent laparoscopic pyloromyotomy successfully without conversion to open operations .The duration of operation was 25-55 min (35.9 ±12.1 min).The nasogastric tube was removed about 6 hours after operation, and oral feeding was given gradually from water to full milk.On the 3-6 d (3.75 ±1.12 d) after operation, the patients were discharged without postoperative complications . The incisional scars had satisfying appearance .Follow-up scheduled for 3 -6 months showed that all the patients were normally developed .Umbilical scar was hardly observed . Conclusion Transumbilical single-site laparoscopic pyloromyotomy is a safe and reliable procedure , with good cosmetic outcomes .