Comparison of the curative effect between laparotomy and laparoscopic pyloromyotomy in the treatment of congenital hypertrophic pyloric stenosis / 新乡医学院学报

ABSTRACT

Objective To compare the clinical effect between laparotomy and laparoscopic pyloromyotomy in the treatment of congenital hypertrophic pyloric stenosis (CHPS).Methods Sixty-three children with CHPS were selected from March 2010 to July 2016 in the Second People's Hospital of Luohe City.The children were divided into laparoscopic operation group (n =31) and laparotomy group (n =32) according to the treatment methods.The children in the laparoscopic operation group were treated with laparoscopic pyloromyotomy,and the children in the laparotomy group were treated with laparotomy.The operation time,intraoperative blood loss,postoperative recovery feeding time,hospitalization time,complications,intragastric pressure and lower esophageal sphincter pressure (LESP) were compared between the two groups.Results There was no significant difference in operation time between the two groups (t =0.277,P ＞ 0.05).The postoperative hospitalization time and recovery feeding time in the laparoscopic operation group were significantly shorter than those in the laparotomy group (t =14.302,17.935;P ＜0.05),and the intraoperative blood loss in the laparoscopic operation group was significantly less than that in the laparotomy group (t =13.064,P ＜ 0.05).There was no significant difference in the intragastric pressure and LESP between the two groups before operation (t =0.316,0.529;P ＞ 0.05).The intragastric pressure after operation was significantly lower than that before operation in the two groups (t =10.613,9.851;P ＜0.05).There was no significant difference in LESP before and after operation in the two groups (t =2.643,2.772;P ＞ 0.05).There was no significant difference in the intragastric pressure and LESP between the two groups after operation (t =0.237,0.329;P ＞ 0.05).The incidence of postoperative complications in the laparotomy group and laparoscopic operation group was 15.63％ (5/32) and 3.23％ (1/31) respectively,the incidence of complications in laparoscopic operation group was significantly lower than that in laparotomy group (x2 =3.991,P ＜ 0.05).Conclusion laparoscopic pyloromyotomy can effectively relieve pyloric stenosis in the treatment of CHPS,and it has the characteristics of small trauma,quick recovery and less complications.