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目的:比较腹腔镜幽门肌切开术(laparoscopic pyloromyotomy,LP)与开腹幽门肌切开术(open pyloromyotomy,OP)治疗先天性肥厚性幽门狭窄(congenital hypertrophic pyloric stenosis,CHPS)的安全性及预后,为临床治疗方案的制定提供循证依据。方法:根据中文关键词“先天性肥厚性幽门狭窄”、“腹腔镜”、“幽门环肌切开术”及英文关键词“congenital hypertrophic pyloric stenosis”、“laparoscopic”、“pyloromyotomy”,分别检索PubMed、Embase、Web of Science、Cochrane图书馆、万方、知网等中英文数据库关于腹腔镜与开腹手术治疗先天性肥厚性幽门狭窄的随机对照试验,检索的最后日期是2020年8月。按《Cochrane Reviewer Handbook》风险评估标准评估文献质量,比较LP、OP两种不同术式患儿手术时间、住院时间、术后完全恢复进食时间及并发症发生率,使用Stata软件进行Meta分析。结果:共纳入6项随机对照研究,共计672例患儿,按手术方式分组,LP组339例,OP组333例。Meta统计分析结果显示,LP组手术时间及全部并发症、主要并发症发生率与OP组比较,差异均无统计学意义(n WMD=0.243,95%n CI为-2.335~2.8201,n P=0.853 ;n RD=-0.013, 95%n CI为-0.056~0.030,n P=0.553;n RD=0.025,95%n CI为-0.002~0.051,n P=0.066)。LP组患儿术后进食时间和住院时间较OP组明显缩短,且差异有统计学意义(n WMD=-1.553, 95%n CI为-1.891~-1.175,n P<0.001;n WMD=-3.536, 95%n CI为-3.975~-3.097,n P<0.001 )。但LP组幽门环肌切开不完全率较OP组高,且差异有统计学意义(n RD=0.044 ,95%n CI为0.005~0.083,n P=0.029)。n 结论:与OP相比,LP治疗CHPS恢复经口全量喂养更快,术后住院时间更短,值得临床推广。但LP幽门环肌切开不全率较高,应予以重视。“,”Objective:To compare the safety and prognosis of laparoscopic (LP) versus open(OP) pyloromyotomy for congenital hypertrophic pyloric stenosis (CHPS).Methods:Based upon the Chinese or English keywords of “ congenital pyloric stenosis laparoscopic” and “ pyloromyotomy” , randomized controlled trials of LP and OP for CHPS were searched in Chinese and English databases, including PubMed, Embase, Cochrane Library, Wanfang and CNKI with the last retrieval date of August 2020. The quality of literatures was assessed according to the risk assessment criteria of Cochrane Reviewer Handbook. Operative duration, length of postoperative stay, time to full feeding and incidence of complications were compared between LP and OP groups. Stata software was utilized for Meta-analysis.Results:A total of 6 randomized controlled studies were included, involving a total of 672 infants, LP 339 and OP 333. No significant differences existed in operative duration (n WMD=0.243, 95%n CI: -2.335~ 2.8201, n P=0.853) , overall complications (n RD= -0.013, 95%n CI: 0.056~0.030, n P=0.553) or major complications (n RD=0.025, 95%n CI: -0.002~0.051, n P=0.066) . As compared with LP, time to full postoperative feeding (n WMD=-1.553, 95%n CI: -1.891~-1.175, n P<0.001) and postoperative hospital stay (n WMD=-3.536, 95%n CI: -3.975~-3.097, n P<0.001) were significantly shorter with statistical significance. However, incomplete pyloromyotomy rate was higher in LP (n RD=0.044, 95%n CI: 0.005~0.083, n P=0.029) than that in OP and the difference was statistically significant.n Conclusions:As compared with OP, LP can shorten time to full postoperative feeding and reduce the length of hospital stay. No difference exists in complications. Thus worthy of wider clinical promotions, it is nevertheless associated with a higher rate of inadequate pyloromyotomy. Adequate attention should be paid.