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首页> 外文期刊>Surgical Endoscopy >Laparoscopic pyloromyotomy for hypertrophic pyloric stenosis: impact of experience on the results in 182 cases.
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Laparoscopic pyloromyotomy for hypertrophic pyloric stenosis: impact of experience on the results in 182 cases.

机译：腹腔镜幽门切开术治疗肥厚性幽门狭窄：182例经验对结果的影响。

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BACKGROUND: There has been discussion about the value of laparoscopic pyloromyotomy (LP) for the treatment of hypertrophic pyloric stenosis (HPS). In their initial small series, the authors reported a relatively high complication rate. The current study was undertaken to investigate the influence of experience with LP on operative time, complication rate, and postoperative hospital stay for a large number of patients. METHODS: Between October 1993 and March 2002, 182 children underwent LP for HPS. These procedures involved 11 surgeons, 4 consultants, and 7 trainees. The end points of the study were operative time, complications, and postoperative hospital stay. The outcome of 146 LPs performed after July 1996 was compared with the outcome of 36 LPs performed before that period. RESULTS: There was no significant difference in the mean operative time between the two series, but the operative time per surgeon dropped with experience. Mucosal perforation was experienced by 8.3% of the patients in the initial series, as compared with 0.7% in the later series. Insufficient pyloromyotomy occurred in 8.3% of the initial series, as compared with 2.7% of the later series. Other minor complications such as wound infection were infrequent and not influenced by further experience. Major wound-related problems did not occur. The LP procedure was easily learned by novices. After about 15 pyloromyotomies, the operative time was approximately 25 min. The length of postoperative hospital stay also dropped with increasing experience. CONCLUSIONS: The value of LP for the treatment of HPS has been proved. The LP procedure is as quick as the open procedure, has a low morbidity, and is devoid of major wound-related problems. Moreover, the procedure seems to be well teachable.
机译：背景：关于腹腔镜幽门切开术（LP）在肥厚性幽门狭窄（HPS）治疗中的价值的讨论已经开始。在最初的小系列文章中，作者报告了较高的并发症发生率。进行本研究的目的是调查LP经验对许多患者的手术时间，并发症发生率和术后住院时间的影响。方法：在1993年10月至2002年3月之间，有182名儿童接受了HPS LP治疗。这些程序涉及11名外科医生，4名顾问和7名学员。研究的终点是手术时间，并发症和术后住院时间。将1996年7月之后执行的146个LP的结果与该时期之前执行的36个LP的结果进行了比较。结果：两个系列的平均手术时间没有显着差异，但是随着经验的增加，每个外科医生的手术时间减少了。在最初的系列中，有8.3％的患者经历了粘膜穿孔，而在以后的系列中则为0.7％。最初的系列中有8.3％的患者进行了幽门切开术，而后来的系列中只有2.7％。其他较小的并发症，如伤口感染很少见，不受进一步经验的影响。没有发生与伤口相关的主要问题。 LP程序很容易被新手学习。进行约15次幽门切开术后，手术时间约为25分钟。随着经验的增加，术后住院时间也缩短了。结论：LP在HPS治疗中的价值已得到证实。 LP手术与开放手术一样快，发病率低，并且没有重大的伤口相关问题。而且，该程序似乎很好地讲授。

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