Comparative Study On Laparoscopic And Open Surgery For The Treatment Of Congenital Hypertrophic Pyloric Stenosis

BackgroundCongenital hypertrophic pyloric stenosis(CHPS)is a common surgical condition in the neonatal period and ranks third in gastrointestinal malformations.It is caused by various causes of pyloric ring muscle hyperplasia and hypertrophy,resulting in pyloric stenosis,prolonged mechanical obstruction,if not treated in time,the child will be malnutrition,weight loss with time extension or even weight loss,electrolyte acid-base balance disorder,jaundice,and even death and other complications.Pyloromyotomy(PRT)is the standard procedure for the treatment of CHPS,including open pyloromyotomy(OP)and laparoscopic pyloromyotomy(LP).In recent years,minimally invasive techniques have developed rapidly,and laparoscopic treatment of CHPS has provided new options for pediatric surgeons and children.At present,there are different opinions on the two methods of LP and OP.ObjectiveTo compare the clinical efficacy of LP and OP in the treatment of CHPS.MethodThe children with CHPS admitted to our hospital from October 2016 to October 2018 were selected as subjects,doing retrospective analysis,the inclusion criteria and exclusion criteria were limited.A total of 58 patients were included.They were divided into open group(n=33)and laparoscopic group according to different surgical methods.(n=25),both groups underwent PRT.Statistical analysis was performed on SPSS21.0 statistical software for the operation time,blood loss,postoperative hospitalization time,postoperative vomiting,and incidence of postoperative wound infection in the two groups.Surgical scars were scored 1 month after surgery using the Vancouver Scar Rating Scale.Result1.Preoperative general data comparison: There were no significant differences in age,gender composition ratio,body weight,pyloric muscle thickness,and pyloric tube length between the two groups(P>0.05).2.Comparison of intraoperative and postoperative conditions: There was no significant difference in the incidence of intraoperative blood loss,postoperative vomiting,and postoperative incision infection(P>0.05).The operation time of the laparoscopic group were longer than those of the open group,and postoperative hospitalization time were shorter than those of the open group,which was statistically significant(P<0.05).3.Comparison of surgical scar scores in 1 month after surgery: Surgical scars were scored using the Vancouver Scar Rating Scale.The scar score in the laparoscopic group was significantly better than that in the open group(P<0.05).ConclusionLP treatment of CHPS is effective and safe,It has the advantages of small surgical trauma,rapid postoperative recovery,short hospital stay,and appearance aesthetics.