Application of transumbilical single-site laparoscopic surgery combined with early enteral nutrition in rapid recovery of congenital duodenal obstruction

doi:10.11958/20221941

Abstract

Abstract:

Objective To investigate the application value of transumbilical single-site laparoscopic surgery combined with early postoperative enteral nutrition (EEN) in rapid recovery of congenital duodenal obstruction. Methods Clinical data of 87 children with duodenal obstruction were analyzed. The children who received three-hole laparoscopic treatment were classified as the three-hole group (n=39), and children who received transumbilical single-site laparoscopic treatment were divided into the single-hole group (conventional feeding, n=26) and the single-hole EEN group (EEN, n=22) according to different postoperative feeding methods. The differences of operation time, postoperative intestinal function recovery time, hospital stay and cost, laboratory indicators and complications were compared between the three groups. Results There was no significant difference in operation time between the three groups (P>0.05). There were no significant differences in the time of initial enteral nutrition, the time to total enteral nutrition, the time of first defecation, the time of postoperative hospitalization, the cost of hospitalization and levels of albumin (ALB), hemoglobin (Hb) and C-reactive protein (CRP) one week after surgery between the single-hole group and the three-hole group (P>0.05). The time of initial enteral nutrition, the time of total enteral nutrition, the time of first defecation, the time of postoperative hospitalization were significantly shortened in the single-hole EEN group than those of the single-hole group (P<0.05), and the Hb level was higher one week after surgery (P<0.05). There were no significant differences in hospital expenses, ALB and CRP levels one week after surgery between the two groups (P>0.05). During follow-up after discharge, there was one case of recurrent intestinal torsion in the single-hole group and the three-hole group, which were cured after re-operation. Conclusion In the treatment of neonatal duodenal obstruction, transumbilical single-site laparoscopic surgery combined with early enteral nutrition is safe, feasible and effective, which can promote early postoperative recovery. The abdominal incision is hidden, which has good clinical application value.

Key words: duodenal obstruction, laparoscopy, enteral nutrition, transumbilical single-site laparoscopic surgery, early enteral nutrition

CLC Number:

R726.566

Figures/Tables 3

References 22

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组别	n	性别（男/女）	入院体质量（kg）	手术日龄（d）	手术类别		手术时间（min）
组别	n	性别（男/女）	入院体质量（kg）	手术日龄（d）	纵切横缝/菱形吻合术	Ladd术	纵切横缝/菱形吻合术	Ladd术
三孔组	39	24/15	3.03±0.55	12.46±5.85	14（35.9）	25（64.1）	110.43±17.37	98.36±21.99
单孔组	26	17/9	3.13±0.47	10.77±4.07	13（50.0）	13（50.0）	117.69±20.70	112.15±22.51
单孔EEN组	22	12/10	3.06±0.40	11.50±3.69	8（36.4）	14（63.6）	115.00±15.19	109.29±19.44
F或χ²		0.599	0.317	0.965	1.473		0.543	2.192

组别	n	性别（男/女）	入院体质量（kg）	手术日龄（d）	手术类别		手术时间（min）
组别	n	性别（男/女）	入院体质量（kg）	手术日龄（d）	纵切横缝/菱形吻合术	Ladd术	纵切横缝/菱形吻合术	Ladd术
三孔组	39	24/15	3.03±0.55	12.46±5.85	14（35.9）	25（64.1）	110.43±17.37	98.36±21.99
单孔组	26	17/9	3.13±0.47	10.77±4.07	13（50.0）	13（50.0）	117.69±20.70	112.15±22.51
单孔EEN组	22	12/10	3.06±0.40	11.50±3.69	8（36.4）	14（63.6）	115.00±15.19	109.29±19.44
F或χ²		0.599	0.317	0.965	1.473		0.543	2.192

组别	n	术后初次肠内营养时间（d）	达到全量肠内营养时间（d）	术后首次排便时间（d）	术后住院时间（d）	住院费用（万元）	术后1周ALB （mg/L）	术后1周Hb （g/L）	术后1周CRP (mg/L)
三孔组	39	6.33±2.66	9.13±2.77	5.15±1.25	12.15±4.33	3.98±0.94	36.68±4.31	121.41±24.42	2.46±1.50
单孔组	26	6.42±1.60	9.62±1.88	4.73±1.25	12.92±2.90	4.05±0.80	37.52±3.40	124.50±24.42	1.73±0.99
单孔EEN组	22	2.45±1.01^ab	6.14±1.36^ab	2.32±0.95^ab	9.18±1.40^ab	3.59±0.44	38.76±3.30	137.77±16.48^ab	1.96±1.42
F		29.861^＊＊	17.099^＊＊	42.966^＊＊	8.104^＊＊	2.309	2.112	3.794^＊	2.467

组别	n	术后初次肠内营养时间（d）	达到全量肠内营养时间（d）	术后首次排便时间（d）	术后住院时间（d）	住院费用（万元）	术后1周ALB （mg/L）	术后1周Hb （g/L）	术后1周CRP (mg/L)
三孔组	39	6.33±2.66	9.13±2.77	5.15±1.25	12.15±4.33	3.98±0.94	36.68±4.31	121.41±24.42	2.46±1.50
单孔组	26	6.42±1.60	9.62±1.88	4.73±1.25	12.92±2.90	4.05±0.80	37.52±3.40	124.50±24.42	1.73±0.99
单孔EEN组	22	2.45±1.01^ab	6.14±1.36^ab	2.32±0.95^ab	9.18±1.40^ab	3.59±0.44	38.76±3.30	137.77±16.48^ab	1.96±1.42
F		29.861^＊＊	17.099^＊＊	42.966^＊＊	8.104^＊＊	2.309	2.112	3.794^＊	2.467