A 9-Year Single Center Experience with Circumumbilical Ramstedt's Pyloromyotomy

Abstract

This is a large single-center retrospective study where, in the era of minimally invasive surgery, Ramstedt's pyloromyotomy via the circumumbilical approach has a low rate of complications and is a safe and feasible method to treat pyloric stenosis. The establishment of feeds soon after surgery minimizes the postoperative in-hospital stay.

Feeding Post-Pyloromyotomy: A Meta-analysis

“…Another 4 studies examined LOS as affected by early versus late feeding regimens. 3,4,13,14 Although early feeding was favored over late, the results were not statistically significant (MD −12.07; 95% CI, −32.46 to 8.31; I 2 94%; P = .25) (Fig 3). When a sensitivity analysis was performed on the 2 studies that classified "early feeding" as first feeding occurring at ≤4 hours, early feeding was still favored although not 5 …”

“…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).…”

“…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.…”

Supernumerary ovary presenting as a paraduodenal duplication cyst

“…However, it has been demonstrated that when IHPS is operated on in a specialized tertiary center, that the infection rate and hospital stay are significantly less [10].…”