Impact of surgical approach on outcome in 622 consecutive pyloromyotomies at a pediatric teaching institution

التفاصيل البيبلوغرافية
العنوان: Impact of surgical approach on outcome in 622 consecutive pyloromyotomies at a pediatric teaching institution
المؤلفون: Julie R. Fuchs, Luka Komidar, David P. Mooney, Len A. Perger
المصدر: Journal of pediatric surgery. 44(11)
سنة النشر: 2009
مصطلحات موضوعية: Male, medicine.medical_specialty, Vomiting, medicine.medical_treatment, Pyloric Stenosis, Hypertrophic, Pyloromyotomy, Pyloric stenosis, Patient safety, Postoperative Complications, Gastroscopy, Preoperative Care, Medicine, Humans, Laparoscopy, Hospitals, Teaching, Pylorus, Surgical approach, medicine.diagnostic_test, Umbilicus, business.industry, Incidence (epidemiology), Incidence, Body Weight, Infant, Newborn, Cosmesis, Infant, Muscle, Smooth, General Medicine, Antibiotic Prophylaxis, Length of Stay, medicine.disease, Pyloromyotomies, Hospitals, Pediatric, Surgery, Treatment Outcome, Pediatrics, Perinatology and Child Health, Female, business
الوصف: Purpose: The aim of this study is to compare the outcome of 3 different approaches to pyloromyotomy in a large single institution series. Methods: Records of consecutive patients undergoing pyloromyotomy for an 8-year period were reviewed. Patients' age, sex, weight, operating time, length of stay, number of emeses, and complications were recorded. Variables were compared between right upper quadrant (RUQ), umbilical (UMB), and laparoscopic (LAP) approaches. Results: Six hundred twenty-two patients were included in the study. Operating time was significantly shorter for LAP and RUQ compared to UMB. Length of stay did not differ between the groups. There were fewer episodes of emesis in the LAP group. There was a trend toward a higher rate of complications in UMB group. Conclusion: Outcomes after pyloromyotomy are institution dependent and cannot be generalized. Patient safety is the first concern, followed by patient comfort and cosmesis. Laparoscopic pyloromyotomy can be as fast and efficient as open, without an increased rate of complications, with excellent cosmetic results, and less analgesic requirement. If skill and experience to replicate good outcomes of laparoscopy are not available, open pyloromyotomy is a safer technique. The UMB approach is an alternative method to achieve good cosmesis without laparoscopy in the hands of a surgeon proficient in this method.
تدمد: 1531-5037
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::af943c2be40bbefbf2b35947c79d307f
https://pubmed.ncbi.nlm.nih.gov/19944219
Rights: CLOSED
رقم الانضمام: edsair.doi.dedup.....af943c2be40bbefbf2b35947c79d307f
قاعدة البيانات: OpenAIRE