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Original Article

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
Journal of the Korean Association of Pediatric Surgeons 2014;20(2):43-47.
Published online: December 30, 2014

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: August 20, 2014   • Revised: October 25, 2014   • Accepted: October 26, 2014

Copyright © 2014 by the Korean Association of Pediatric Surgeons

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.

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  • 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

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

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

Values are presented as ratio or median (range).

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

jkaps-20-43-i001.jpg
Table 2
Clinical Outcomes Treated by OP or LP of Hypertrophic Pyloric Stenosis

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

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

jkaps-20-43-i002.jpg

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Comparison of Pyloromyotomy with Supraumbilical Incision and Laparoscopic Pyloromyotomy for Hypertrophic Pyloric Stenosis Performed by a Single Surgeon
J Korean Assoc Pediatr Surg. 2014;20(2):43-47.   Published online December 30, 2014
DOI: https://doi.org/10.13029/jkaps.2014.20.2.43
Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.
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Include:
Comparison of Pyloromyotomy with Supraumbilical Incision and Laparoscopic Pyloromyotomy for Hypertrophic Pyloric Stenosis Performed by a Single Surgeon
J Korean Assoc Pediatr Surg. 2014;20(2):43-47.   Published online December 30, 2014
DOI: https://doi.org/10.13029/jkaps.2014.20.2.43
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Comparison of Pyloromyotomy with Supraumbilical Incision and Laparoscopic Pyloromyotomy for Hypertrophic Pyloric Stenosis Performed by a Single Surgeon
Image
Fig. 1 Incision of supraumbilical open pyloromyotomy (supraumbilical incision) (A) and laparoscopic pyloromyotomy (B).

Fig. 1

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

Demographic Data of of HPS Patients

Values are presented as ratio or median (range).

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

Clinical Outcomes Treated by OP or LP of Hypertrophic Pyloric Stenosis

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

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

Table 1 Demographic Data of of HPS Patients

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

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

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

Table 1

Table 2

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