The umbilical fold approach to pyloromyotomy: is it a safe alternative to the right upper-quadrant approach?

Leinwand, Michael; Shaul, Donald B.; Anderson, Kathryn D.

doi:10.1016/s1072-7515(99)00136-2

Cited by 59 publications

(45 citation statements)

References 17 publications

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“…The pyloromyotomy is not without complications, although they are uncommon. Most recent reports about pyloromyotomy concern the differences between the procedures through the umbilical route [2,4,11,15,19] or the laparoscopic technique [3,7,9,17,18,20]. Until now a debate has gone on as to whether this procedure can be safely performed in general hospitals with special interest in surgery in children.…”

Section: Discussionmentioning

confidence: 99%

“…In the pediatric center the umbilical incision was increasingly used from 2000 onwards. The pyloromyotomies were not performed by laparoscopy but with an open extramucosal procedure in both centers, according to Ramstedt [11]. The pyloromyotomy is established by a sero-muscular incision of the enlarged pylorus; the incised layers are spread with a blunt dissector until the mucosa is free to bulge into the split muscle.…”

Section: Methodsmentioning

confidence: 99%

“…The current surgical procedure of choice is the pyloromyotomy according to Ramstedt [11]. Intra-operative complications, such as duodenal perforation occur in 4% of patients operated on for IHPS, and in 6% of the patients the post-operative period is complicated with one or more of the following unfavorable conditions: wound infections, incisional hernia, incomplete pyloromyotomy, and persistent vomiting [10].…”

Section: Introductionmentioning

confidence: 99%

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Can pyloromyotomy for infantile hypertrophic pyloric stenosis be performed in any hospital?

et al. 2006

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In order to document the incidence of perioperative complications in patients with infantile hypertrophic pyloric stenosis, a descriptive cohort study was performed in two teaching hospitals in the Netherlands. One hospital specialized in pediatric surgery and the other was a general surgery teaching hospital. All consecutive infants who underwent pyloromyotomy for the diagnosis hypertrophic pyloric stenosis in both hospitals between 1998 and 2002 were included. The children were diagnosed and treated according to a standard protocol. From all charts, complications durante- and post-operationem were recorded. A total of 256 pyloromyotomies were performed. Registered perioperative complications were duodenal mucosal perforation (n=6; 2%). Perioperatively unrecognized duodenal mucosal perforation occurred four times (1%). One re-operation was performed for an incomplete pyloromyotomy (0.3%). Persistent vomiting after the operation occurred in 18 children (7%). A large majority of postoperative complications were wound infections (n=16; 6%), 12 after right upper quadrant incision and 4 after umbilical incision; most of them were treated with antibiotics and/or incision for drainage of an abscess. An incisional hernia occurred four times. Prolonged vomiting was the only postoperative complication that differed significantly between the two teaching hospitals. The overall percentages of complications were equal to complication rates in literature, and since there were no extensive differences in major complications between the two teaching hospitals in this study, we can conclude that pyloromyotomy can be performed safely in specialized centers and in general centers provided with a multidisciplinary team.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Can pyloromyotomy for infantile hypertrophic pyloric stenosis be performed in any hospital?

et al. 2006

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“…In our study, the median postoperative stay was 6 days, which compares well with the 3 to 7 days reported in other series. 12,20 The major limitation of our study was the retrospectivenature of the study. In addition, a large prospective study allowed us to demonstrate all possible etiological factors, which may yield a new research topic for the etiology of the IHPS.…”

Section: Discussionmentioning

confidence: 99%

“…12,19 Intra-operative complications such as duodenal perforation occur in 4% of patients operated on for IHPS and in 6% of the patients the post-operative period is complicated with one or more of the following unfavorable con- ditions like wound infections, incisional hernia, incomplete pyloromyotomy, and persistent vomiting. 19,20 Other large series have varied widely in reported complication rates such as 3% to 60% for postoperative vomiting. 19,21 There was no inadvertent mucosal perforation in our series.…”

Section: Discussionmentioning

confidence: 99%

Seasonal Effect on the Development of Infantile Hypertrophic Pyloric Stenosis

Özgüner¹,

Karaman²,

Çavuşoğlu³

et al. 2013

Turkiye Klinikleri J Med Sci

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820nfantile hypertrophic pyloric stenosis (IHPS) is the most common surgical cause of vomiting in infants. This disorder is characterized by hypertrophy and hyperplasia of the circular muscle layer of the pylorus, Seasonal Effect on the Development of Infantile Hypertrophic Pyloric Stenosis A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : The aim of this report was to determine if seasonal variation exists in the incidence of pyloric stenosis and to review the management of infantile hypertrophic pyloric stenosis (IHPS) in a single tertiary pediatric hospital over a seven-year period. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : We conducted a retrospective chart review of all patients who underwent pyloromyotomy between October 2004 and October 2011. Patient data and laboratory results on admission were recorded from medical charts. The total and postoperative length of stay was calculated from the date of admission, surgery and discharge. Patients were divided into four groups according to seasons as winter, spring, summer and autumn. R Re es su ul lt ts s: : A total of 55 pyloromyotomies were performed. Forty-seven patients were male (85.5%) and 8 were female (14.5%). The age distribution of the patients varied from 3 weeks to 13 weeks (median 6 weeks). There was no perioperative mortality. Oral feeding was achieved by 24 hours in 78.2% of infants and there was persistent vomiting in only 30.9%. There was no significant difference between the groups in terms of age, gender, weight, plasma pH, HCO3, Cl-, and K+ values; in addition, ultrasonographic findings were similar in each group. The highest rate of pyloromyotomy was in spring and the lowest in winter and summer; this difference was statistically significant (p=0.0049). C Co on nc cl lu us si io on n: : In conclusion, seasonal variation of the hypertrophic pyloric stenosis suggests a possible etiological role for environmental factors and pyloromyotomy is the best treatment of IHPS that can be undertaken safely in specialized pediatric centers. K Ke ey y W Wo or rd ds s: : Alkalosis; pyloric stenosis, hypertrophic; hypokalemia; infant; seasons Ö ÖZ ZE ET T A Am ma aç ç: : Bu çalışmanın amacı, pilor stenozu insidansının mevsimsel ilişkisi olup olmadığını saptamak ve üçüncü basamak bir çocuk hastanesinin yedi yıllık bir süre boyunca infantil hipertrofik pilor stenozunun tedavisindeki deneyimini gözden geçirmektir. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Ekim 2004-Ekim 2011 tarihleri arasında hastanemizde piloromiyotomi ameliyatı geçiren tüm hastaların dosya kayıtları gözden geçirildi. Dosya kayıtlarından hastaların demografik verileri, başvuru sırasındaki laboratuar sonuçları, ameliyat sonrası yatış süreleri ve hastanedeki toplam yatış süreleri kaydedildi. Hastalar başvurdukları mevsimlere göre kış, ilkbahar, yaz ve sonbahar olarak dört gruba ayrıldı. B Bu ul lg gu ul la ar r: : Kayıtlardan elde edilen bilgilere göre toplam 55 hastada piloromiyotomi yapılmıştı. Hastaların 47 (%85,5)'si erkek ve 8 (%14,5)'i kızdı. Hastalar...

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