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Lee, Kim, Kim, Namgoong, and Hwang: Comparison of Pyloromyotomy with Supraumbilical Incision and Laparoscopic Pyloromyotomy for Hypertrophic Pyloric Stenosis Performed by a Single Surgeon
Original Article

Journal of the Korean Association of Pediatric Surgeons 2014; 20(2): 43-47.

Published online: 30 December 2014

DOI: https://doi.org/10.13029/jkaps.2014.20.2.43

Comparison of Pyloromyotomy with Supraumbilical Incision and Laparoscopic Pyloromyotomy for Hypertrophic Pyloric Stenosis Performed by a Single Surgeon

Jong-Woo Lee, Dae Yeon Kim, Seong Chul Kim, Jung-Man Namgoong, Ji-Hee Hwang

Department of Pediatric Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Correspondence: Dae Yeon Kim, Department of Pediatric Surgery, Asan Medical Center Children's Hospital, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Korea. Tel: +82-2-3010-3961, Fax: +82-2-474-9027, kimdy@amc.seoul.kr

Received 20 August 2014       Revised 25 October 2014       Accepted 26 October 2014

Copyright © 2014 by the Korean Association of Pediatric Surgeons

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

Hypertrophic pyloric stenosis (HPS) is known to be one of the most common cause of surgery for infants and pyloromyotomy was considered to the standard treatment. There has been an ongoing debate about whether laparoscopic pyloromyotomy (LP) or open pyloromyotomy (OP) is the best option for treating HPS. The aim of this study is to evaluate safety and effectiveness of LP by comparing the clinical results of both surgical strategies performed by single surgeon.

Methods

Between January 2000 and December 2013, 60 patients who underwent pyloromyotomy at Asan Medical Center performed by a surgeon were followed: open-supraumbilical incision (n=36) and LP (n=24). The parameters included sex, age and body weight at operation. Clinical outcomes included operation time, time to full feeding, postoperative hospital stay, and postoperative complications.

Results

There were no significant differences in characteristics, postoperative hospital stay between the two groups. Time to full feeding was shorter in LP (OP 24.5 hours vs. LP 19.8 hours; p=0.063). In contrast, the mean operation time was longer in LP (OP 37.5 minutes vs. LP 43.5 minutes; p=0.072). Complications such as perforation of mucosal layer (OP 1 vs. LP 0) and wound problems (OP 2 vs. LP 0) were found to be not worse in laparoscopic group as compared with open group.

Conclusion

There has no difference both laparoscopic and open-supraumbilical incision in terms of postoperative hospital stay, time to full feeds and frequency of complications.

Keywords: Hypertrophic pyloric stenosis, Pyloromyotomy, Laparoscopy

Figures and Tables

Fig. 1
Incision of supraumbilical open pyloromyotomy (supraumbilical incision) (A) and laparoscopic pyloromyotomy (B).
jkaps-20-43-g001
Table 1
Demographic Data of of HPS Patients
jkaps-20-43-i001

Values are presented as ratio or median (range).

HPS, hypertrophic pyloric stenosis; OP, open pyloromyotomy (supraumbilical incision); LP, laparoscopic pyloromyotomy.

Table 2
Clinical Outcomes Treated by OP or LP of Hypertrophic Pyloric Stenosis
jkaps-20-43-i002

Values are presented as median (range), n (%), or mean±SD.

OP, open pyloromyotomy (supraumbilical incision); LP, laparoscopic pyloromyotomy.

Notes

No potential conflict of interest relevant to this article was reported.

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