J Korean Assoc Pediatr Surg.  2014 Dec;20(2):43-47. 10.13029/jkaps.2014.20.2.43.

Comparison of Pyloromyotomy with Supraumbilical Incision and Laparoscopic Pyloromyotomy for Hypertrophic Pyloric Stenosis Performed by a Single Surgeon

Affiliations
  • 1Department of Pediatric Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. kimdy@amc.seoul.kr

Abstract

PURPOSE
Hypertrophic pyloric stenosis (HPS) is known to be one of the most common cause of surgery for infants and pyloromyotomy was considered to the standard treatment. There has been an ongoing debate about whether laparoscopic pyloromyotomy (LP) or open pyloromyotomy (OP) is the best option for treating HPS. The aim of this study is to evaluate safety and effectiveness of LP by comparing the clinical results of both surgical strategies performed by single surgeon.
METHODS
Between January 2000 and December 2013, 60 patients who underwent pyloromyotomy at Asan Medical Center performed by a surgeon were followed: open-supraumbilical incision (n=36) and LP (n=24). The parameters included sex, age and body weight at operation. Clinical outcomes included operation time, time to full feeding, postoperative hospital stay, and postoperative complications.
RESULTS
There were no significant differences in characteristics, postoperative hospital stay between the two groups. Time to full feeding was shorter in LP (OP 24.5 hours vs. LP 19.8 hours; p=0.063). In contrast, the mean operation time was longer in LP (OP 37.5 minutes vs. LP 43.5 minutes; p=0.072). Complications such as perforation of mucosal layer (OP 1 vs. LP 0) and wound problems (OP 2 vs. LP 0) were found to be not worse in laparoscopic group as compared with open group.
CONCLUSION
There has no difference both laparoscopic and open-supraumbilical incision in terms of postoperative hospital stay, time to full feeds and frequency of complications.

Keyword

Hypertrophic pyloric stenosis; Pyloromyotomy; Laparoscopy

MeSH Terms

Body Weight
Chungcheongnam-do
Humans
Infant
Laparoscopy
Length of Stay
Postoperative Complications
Pyloric Stenosis, Hypertrophic*
Wounds and Injuries
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