Laparoscopic pyloromyotomy is both safe and effective in a district hospital

Surg Endosc. 2008 Jan;22(1):151-3. doi: 10.1007/s00464-007-9392-8. Epub 2007 May 24.

Abstract

Introduction: Functional operations of the gastrointestinal tract are ideal indications for minimal-access surgery. The aim of this paper was to assess the safety and potential benefits of the laparoscopic Ramstedt pyloromyotomy using the experience of a single surgeon in a district general hospital.

Methods: 90 consecutive infants underwent pyloromyotomy: 35 open procedures and 55 laparoscopic procedures. This is a retrospective study but the operative data of the laparoscopic group were collected prospectively.

Results: There were no differences in demographic data between the groups. The open group had a shorter mean operating time, 22.14 min, than the laparoscopic group, 26.04 min (p = 0.022). There was no significant difference in the time to full feed between the two groups (p = 0.076). 62.9% of the infants in the open group vomited compared with only 43.4% in the laparoscopic group (p = 0.058). The laparoscopic group had shorter postoperative stay, 62.33 hours, compared to 91.89 hours (p = 0.001). There was one reoperation in each group: for complete wound dehiscence in the open group and for incomplete myotomy in the laparoscopic group.

Conclusions: Laparoscopic pyloromyotomy (LPM) is as safe as the open procedure and has the potential benefits of shorter hospital stay and improved cosmesis.

Publication types

  • Comparative Study

MeSH terms

  • Chi-Square Distribution
  • Cohort Studies
  • Digestive System Surgical Procedures / methods
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Infant, Newborn
  • Laparoscopy / methods*
  • Laparotomy / methods*
  • Length of Stay
  • Male
  • Probability
  • Pyloric Stenosis, Hypertrophic / diagnosis
  • Pyloric Stenosis, Hypertrophic / surgery*
  • Pylorus / surgery*
  • Retrospective Studies
  • Risk Assessment
  • Statistics, Nonparametric
  • Treatment Outcome