经口内镜幽门括约肌切开术治疗婴幼儿先天性肥厚性幽门狭窄的疗效与预后研究

Efficacy and prognosis of gastric peroral endoscopic myotomy in the treatment of infants with congenital hypertrophic pyloric stenosis

摘要:

目的 探讨经口内镜幽门括约肌切开术（G-POEM）治疗婴幼儿先天性肥厚性幽门狭窄（CHPS）的疗效与预后情况。方法 回顾性分析2020年1月－2025年1月该院收治的60例CHPS患儿的临床资料。根据不同手术入路，将患儿分为对照组（n = 29）和观察组（n = 31）。对照组采取腹腔镜下幽门肌切开术（LP），观察组采取G-POEM。统计两组患儿围手术期指标和并发症发生情况。结果 观察组手术时间长于对照组，恢复全量喂养时间和术后住院时间短于对照组，家属满意度评分高于对照组，差异均有统计学意义（P < 0.05）。两组患儿并发症总发生率和术后3个月体重增长情况比较，差异均无统计学意义（P > 0.05）。观察组术后随访3个月，未发生体表瘢痕。结论 G-POEM治疗婴幼儿CHPS是安全、可行的，虽然手术操作时间略长，但具有体表无瘢痕、术后恢复快和住院时间短等优势，具有一定的临床应用价值。

Abstract:

Objective To evaluate the therapeutic outcomes and prognosis of gastric peroral endoscopic pyloromyotomy (G-POEM) for congenital hypertrophic pyloric stenosis (CHPS) in infants.Methods We retrospectively reviewed clinical records of 60 infants diagnosed with CHPS and treated at our institution from January 2020 to January 2025. The pediatric patients were assigned by surgical approach to a laparoscopic pyloromyotomy (LP) control group (n = 29) or a G-POEM observation group (n = 31). Perioperative parameters and complication rates were compared between the two groups.Results The observation group required a modestly longer operative time compared with the control group, had shorter time to reach full oral feeding and shorter postoperative hospital stays compared with the control group, and caregiver satisfaction scores were higher in the observation group compared with the control group, the differnces were statistically significant (P < 0.05). There were no statistically significant differences in the overall complication rate and weight gain at 3 months postoperatively between the two groups (P > 0.05); The observation group underwent a 3-month postoperative follow-up, during which no superficial scars were observed.Conclusion G-POEM is a safe and practicable minimally invasive technique for treating CHPS in infants. Despite a slightly increased operative duration, it offers advantages of no external scarring, faster postoperative recovery and shorter hospitalization, representing an effective surgical option for this condition.