Open versus Laparoscopic Pyloromyotomy for Infantile Hypertrophic Pyloric Stenosis | ||
| Ain Shams Journal of Surgery | ||
| Volume 17, Issue 1, January 2024, Pages 29-39 PDF (501.28 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/asjs.2024.336998 | ||
| Authors | ||
| Mohamed Gamal Qassem* 1; Amr Hisham Dahish1; Mohamed Hisham Soliman2; Mohammed Matar1 | ||
| 1Department of General Surgery, Faculty of Medicine, Ain Shams University, Egypt | ||
| 2Department of Pediatric Surgery, Faculty of Medicine, Ain Shams University, Egypt | ||
| Abstract | ||
| Introduction: Infantile hypertrophic pyloric stenosis (IHPS) is the most common surgical cause of vomiting in infancy which can be treated by pyloromyotomy after correction of pH and electrolytes imbalance. Infantile hypertrophic pyloric stenosis (IHPS) is the most common surgical cause of vomiting in infancy which can be treated by pyloromyotomy after correction of pH and electrolytes imbalance. Aim of work: To Compare between laparoscopic and open (Right upper quadrant incision) approach for pyloromyotomy in the management of infants with infantile hypertrophic pyloric stenosis regard their operative time, hospital stay, postoperative complications and cosmoses. Patients and methods: A prospective study of 40 patients with IHPS was done. (20 by laparoscopy and 20 by open approach) To Compare between laparoscopic and open (Right upper quadrant incision) approach in pyloromyotomy in infants with infantile hypertrophic pyloric stenosis regard their operative time, hospital stay, postoperative complications and cosmoses. Results: This study was conducted on 40 patients with infantile hypertrophic pyloric stenosis (IHPS) randomly divided into two groups, A and B. Laparoscopic pyloromyotomy was performed on group A while Group B underwent open pyloromyotomy through a transverse right upper quadrant incision. Throughout the study, 31 (77.5%) male babies were diagnosed with IHPS, while only 9 (22.5%) female babies were diagnosed during the study with 3.4:1 male to female Ratio. Open pyloromyotomy needed less operative time (mean 28.6 mins ), while laparoscopic pyloromyotomy took more time ( Mean 36.8 mins ) intraoperatively and needs more experience for the surgeon in dealing with laparoscopic tools. According to the study, Patients underwent open pyloromyotomy needed more hospital stay ( Mean 2.9 days ) till achievement of full feeding than laparoscopic pyloromyotomy ( mean 1.7 days ). Through the study, we addressed cosmetic results according to patient’s parent or guardian satisfaction to cosmetic results. 4 cases’ (20% of the total group) Parents in group A complained of the shape of the scar and wished if it was better (Shown in the next picture), while parents in Group B was satisfied with the post operative scar which was mostly unnoticed. Conclusion: The study revealed that laparoscopic pyloromyotomy has excellent cosmesis, less hospital stay, with operative time and complications comparable rates to open approach, so it can be considered as a standard technique for treatment of IHPS. | ||
| Keywords | ||
| Infantile hypertrophic pyloric stenosis; pyloric stenosis; pyloromyotomy; open; laparoscopy | ||
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