Pediatrics and neonatology · 2026
Laparoscopic management of congenital pyloric Atresia: A case series and surgical perspective.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Shchapov Nikolay, Ekimovskaya Ekaterina, Kudelin Viacheslav, Kulikov Denis, Andreeva Elena, Ivanitskaya Olga, Bullikh Pavel
Аннотация
BACKGROUND: Congenital pyloric atresia (CPA) is an extremely rare neonatal gastric outlet obstruction (approximately 1 in 100,000 live births) that requires prompt surgical correction. It can occur in isolation or in association with junctional epidermolysis bullosa (JEB), and historically it has been managed with open surgery. Laparoscopic repair has only been reported in a few cases, so its safety and efficacy remain unclear.
METHODS: We retrospectively reviewed five paediatric patients with Type I CPA (pyloric web) who were treated laparoscopically at three centers between 2020 and 2024. Patients' ages ranged from 2 days to 15 months (four neonates and one older infant). Data on clinical presentation, diagnostic work-up, surgical technique, and outcomes were collected from medical records and follow-up interviews.
FINDINGS: All five patients underwent successful laparoscopic pyloric web resection and Heineke-Mikulicz pyloroplasty, with no conversions to open surgery. There were no intraoperative complications. One neonate (who had severe hypoxic-ischaemic encephalopathy) died of unrelated causes, whereas the remaining four patients recovered well. Full oral feeds were achieved within one week postoperatively in all survivors. At 1-5 years of follow-up, all four surviving children were thriving with normal growth and no recurrent obstruction. Notably, the 15-month-old infant in our series illustrates that a small perforated pyloric web can initially evade diagnosis; however, targeted imaging eventually confirmed the gastric outlet obstruction.
INTERPRETATION: In this case series, laparoscopic management of CPA proved feasible, safe, and effective in experienced paediatric surgical centers. The minimally invasive approach achieved outcomes comparable to those historically reported for open surgery. Early clinical recognition and appropriate imaging are critical for timely diagnosis, especially in partial or intermittent obstructions. Where surgical expertise and equipment are available, laparoscopy may be the preferred first-line treatment for Type I pyloric atresia, offering a definitive cure with minimal invasiveness.
METHODS: We retrospectively reviewed five paediatric patients with Type I CPA (pyloric web) who were treated laparoscopically at three centers between 2020 and 2024. Patients' ages ranged from 2 days to 15 months (four neonates and one older infant). Data on clinical presentation, diagnostic work-up, surgical technique, and outcomes were collected from medical records and follow-up interviews.
FINDINGS: All five patients underwent successful laparoscopic pyloric web resection and Heineke-Mikulicz pyloroplasty, with no conversions to open surgery. There were no intraoperative complications. One neonate (who had severe hypoxic-ischaemic encephalopathy) died of unrelated causes, whereas the remaining four patients recovered well. Full oral feeds were achieved within one week postoperatively in all survivors. At 1-5 years of follow-up, all four surviving children were thriving with normal growth and no recurrent obstruction. Notably, the 15-month-old infant in our series illustrates that a small perforated pyloric web can initially evade diagnosis; however, targeted imaging eventually confirmed the gastric outlet obstruction.
INTERPRETATION: In this case series, laparoscopic management of CPA proved feasible, safe, and effective in experienced paediatric surgical centers. The minimally invasive approach achieved outcomes comparable to those historically reported for open surgery. Early clinical recognition and appropriate imaging are critical for timely diagnosis, especially in partial or intermittent obstructions. Where surgical expertise and equipment are available, laparoscopy may be the preferred first-line treatment for Type I pyloric atresia, offering a definitive cure with minimal invasiveness.