Postoperative ad lib feeding for hypertrophic pyloric stenosis

Feeding Post-Pyloromyotomy: A Meta-analysis

“…Wheeler et al 14 also did not describe 3 of the 7 items, and although their method of sequence generation was assessed to be low risk, allocation concealment (unmarked, folded sheets) had a high risk of bias. In all 3 studies blinding was not possible for patients, personnel, or outcome assessors, and because outcomes may be influenced by this lack of blinding, these Table 2) The remaining 11 nonrandomized studies [1][2][3][4]9,13,[15][16][17][18]20 were assessed for methodological quality with the MINORS tool, 7 for which the majority of items were assessed similarly across studies (Table 1; see Supplemental Table 4 for greater detail). Few or no studies reported on the items "prospective collection of data" (reported in only 1 of 11 [9%] studies 16 ), "unbiased assessment of the study endpoint" (0 in 11 [0%] studies), and "prospective calculation of the study size" (0 in 11 [0%] studies).…”

“…Meta-analysis of the 6 studies 1,3,[16][17][18][19] that reported on the LOS for ad libitum versus structured feeding regimen indicated that LOS was significantly shorter for an ad libitum feeding regimen (MD −4.66; 95% CI, −8.38 to −0.95; I 2 73%; P = .01) (Fig 2). Another 4 studies examined LOS as affected by early versus late feeding regimens.…”

“…Of these, 14 studies (and 1 companion study 11 ) met our predefined eligibility criteria and were included in this systematic review (Fig 1). [1][2][3][4]9,[12][13][14][15][16][17][18][19][20] Seven of the 14 studies compared feeding regimens that differed with respect to time of first feed (early versus late feeding), [2][3][4][12][13][14]20 6 studies compared the approach to feeding (ad libitum versus structured feeding), 1,3,[16][17][18][19] and 4 studies compared advancement of feeding (gradual versus rapid feeding) 4,9,14,15 ( Table 1 and Supplemental Table 3). Of the 14 studies included, only 3 (21%) used a randomized controlled trial study design, 12,14,19 and the remaining 11 studies (79%) used a nonrandomized comparative control approach.…”

“…Of the 14 studies included, only 3 (21%) used a randomized controlled trial study design, 12,14,19 and the remaining 11 studies (79%) used a nonrandomized comparative control approach. [1][2][3][4]9,13,[15][16][17][18]20 The majority originated in the United States (n = 7, 50%) 1,4,[15][16][17][18][19] or the United Kingdom (n = 3, 21%), 2,12,14 with 2 studies originating in Ireland (14%), 13,20 1 in the Netherlands (7%), 3 and 1 in Austria (7%) 9 (Table 1). A total of 2124 patients were followed in the 14 included studies.…”

Congenital Hypertrophic Pyloric Stenosis At A Tertiary Care Hospital: A Surgical Experience With 30 Infants

“…This management was similar to Shwartz who used 5 % dextrose with 1⁄2 normal saline and Hisham Nazerwho used Ringer's lactate to correct dehydration and metabolic disturbances [24,25] .…”