Pyloromyotomy

Randomized control trial of laparoscopic vs open technique

Sabina Siddiqui, Robert Heidel, Carlos Angel, Alfred P. Kennedy

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Purpose: Open pyloromyotomy remains as the criterion standard treatment for hypertrophic pyloric stenosis with the laparoscopic approach rapidly gaining adoption. We present a prospective, randomized trial between the 2 approaches. Methods: After institutional review board approval, 98 patients with hypertrophic pyloric stenosis were consecutively randomized to either open or laparoscopic pyloromyotomy. Postoperative and hospital course were evaluated by review of the hospital records and long-term follow-up with scripted telephone survey using Likert scales. The length of operating room time, surgical procedure, postoperative stay, time to refeeding, and complications were evaluated. Secondary outcomes of cosmetic results and parental satisfaction were determined. Results: Ninety-eight patients were enrolled during a 4-year period. There were no significant differences between 2 groups on all primary outcomes. There were 3 complications in the open group-a wound dehiscence, a surgical site infection, and a gastric serosal tear-and 2 complications in the laparoscopic group-mucosal perforation and a suture granuloma. In long-term follow-up on 72 patients (56 months), parents described significant cosmetic results with laparoscopic approach. Conclusions: There was no difference in operating time, hospital stay, or refeeding patterns between open and laparoscopic pyloromyotomy. The complication rates were similar between the 2 methods. However, long-term cosmetic results were significantly superior in the laparoscopic group.

Original languageEnglish (US)
Pages (from-to)93-98
Number of pages6
JournalJournal of pediatric surgery
Volume47
Issue number1
DOIs
StatePublished - Jan 1 2012

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Cosmetics
Hypertrophic Pyloric Stenosis
Surgical Wound Infection
Hospital Records
Postoperative Care
Research Ethics Committees
Operating Rooms
Granuloma
Tears
Telephone
Sutures
Length of Stay
Stomach
Parents
Wounds and Injuries
Therapeutics
Surveys and Questionnaires

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pediatrics, Perinatology, and Child Health

Cite this

Pyloromyotomy : Randomized control trial of laparoscopic vs open technique. / Siddiqui, Sabina; Heidel, Robert; Angel, Carlos; Kennedy, Alfred P.

In: Journal of pediatric surgery, Vol. 47, No. 1, 01.01.2012, p. 93-98.

Research output: Contribution to journalArticle

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