Abdominal wall lifting vs carbon dioxide elicited pneumoperitoneum for laparascopic pyloromyotomy

Abstract

Objective To compare the two ways for laparoscopic pyloromyotomy and evaluate the clinical effects of gasless laparoscopic pyloromyotomy with abdominal wall lifting. Methods Sixty-six infants with congenital hypertrophic pyloric stenosis were referred to Children's hospital Zhejiang u-niversity school of medicine from Mar 2006 to Sep 2007. Among them,21 were performed laparoscopic pyloromyotomy with abdominal wall lifting(group A),45 were performed laparoscopic pyloromyotomy with pneumoperitoneum (group B). Their vital signs and blood gas analysis during the operations, complications and cost were watched. Results Ten minutes after pneumoperitoneum beginning, the data of pH, PCO2 and HCO3- change a lot from the preoperative, there are statistically significant differences (P<0.05). In group A,all data were stable and there is no statistically difference. The oc-casional vomiting rates of two groups are similar. There are statistically significant differences between the two groups at the respiratory tract infection rate, hospital days and medical cost(P<0.05). Conclu-sions Laparoscopic pyloromyotomy with abdominal wall lifting is a useful and effective method for congenital hypertrophic pyloric stenosis. Key words: Hypertrophic pyloric stenosis; Laparoscopic surgical procedures; Pneumoperitone-um, artificial