Objective: To evaluate the efficacy and safety of transumbilical single-site laparoscopic surgery for congenital duodenal obstruction (CDO) in neonates.
Methods: A retrospective analysis of clinical data of 15 patients with CDO undergoing transumbilical single-site laparoscopic treatment during November 2017 and January 2018 (single-site group), and 20 patients with CDO undergoing conventional three-hole laparoscopic treatment during August 2017 and October 2017 (three-hole group) was performed. All patients were from the Children's Hospital, Zhejiang University School of Medicine. The operation time, time of initial feeding, time of adequate feeding, length of hospital stay after operation and postoperative complications were compared between two groups.
Results: The operations were completed in all patients. No patient converted to laparotomy, and no massive hemorrhage was observed during operation. The operation time of single-site group was (90±10) min for patients with duodenal diamond-shaped anastomosis and (81±15) min for patients with Ladd operation, while those of three-hole group were (85±9) min and (72±11) min, respectively. Postoperative initial feeding time of single-site group was (5.0±1.0) d, and that of the three-hole group was (4.8±0.8) d. The adequate feeding time was (9.0±1.2) d in the single-site group, and (9.3±0.8) d in the three-hole group. The length of hospital stay after operation was (11.2±2.5) d in the single-site group, and (11.5±2.8) d in the three-hole group. There was no significant difference in operation time, postoperative initial feeding time, adequate feeding time and length of hospital stay after operation between two groups (all P>0.05).
Conclusions: Transumbilical single-site laparoscopic surgery for CDO in neonates is safe and effective, and the postoperative abdominal scar is more hidden.
目的: 探讨经脐单部位腹腔镜手术治疗新生儿先天性十二指肠梗阻（CDO）的疗效和安全性。
方法: 回顾性分析2017年11月至2018年1月在浙江大学医学院附属儿童医院行经脐单部位腹腔镜手术治疗CDO的新生儿15例（单部位组），以及2017年8至10月采用传统三孔法腹腔镜手术治疗CDO的新生儿20例（三孔组）的临床资料。比较两组手术时间、术后初次进食时间、术后足量进食时间、术后住院天数和并发症等。
结果: 两组手术均顺利完成，无中转开腹手术者，无术中大出血发生。单部位组手术时间十二指肠菱形吻合术为（90±10）min，拉德手术为（81±15）min；三孔组手术时间十二指肠菱形吻合术为（85±9）min，拉德手术为（72±11）min，两组差异均无统计学意义（均 P>0.05）。单部位组术后初次进食时间为（5.0±1.0）d，术后足量进食时间为（9.0±1.2）d；三孔组术后初次进食时间为（4.8±0.8）d，术后足量进食时间为（9.3±0.8）d，差异均无统计学意义（均 P>0.05）。术后住院天数单部位组为（11.2±2.5）d，三孔组为（11.5±2.8）d，差异亦无统计学意义（ P>0.05）。
结论: 经脐单部位腹腔镜手术治疗新生儿CDO与传统三孔法腹腔镜手术治疗同样安全有效，并且术后腹部切口更加隐匿。