Differences in Outcomes Based on Sex for Pediatric Patients Undergoing Pyloromyotomy

Massoumi, Roxanne L.; Sakai‐Bizmark, Rie; Tom, Cynthia M.; Howell, Erin; Childers, Christopher P.; Jen, Howard C.; Lee, Steven L.

doi:10.1016/j.jss.2019.07.042

Cited by 5 publications

(3 citation statements)

References 23 publications

(34 reference statements)

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“…The LOS of HPS patients was longer in Germany than in most other countries. The median total LOS in our study was 6.3 days, which is in line with Cascio and Leong ( 30 , 31 ) but also longer than that in other studies ( 25 , 28 , 32 ). In addition to the DRG system, which encourages a certain length of stay, possible reasons are the lack of possibilities to perform non-urgent surgery on a weekend.…”

Section: Discussionsupporting

confidence: 92%

Nationwide trends of laparoscopic pyloromyotomy in patients with infantile hypertrophic pyloric stenosis in Germany: A slow path forward

et al. 2023

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Since its introduction, laparoscopic pyloromyotomy (LP), has become increasingly popular in many countries. We have noticed an attenuated trend in Germany. The aim of this study was to analyse the distribution of open and LP in Germany. The national database of administrative claims data of the Institute for the Remuneration System in Hospitals (InEK) was analysed regarding numbers of patients with pyloromyotomy in the years 2019–2021. The German quality reports of the hospitals of 2019 and 2020 were analyzed regarding the number of procedures performed per hospital and pediatric surgical department. A total of 2050 patients underwent pyloromyotomy. The incidence of hypertrophic pylorus stenosis (HPS) was 699 and 657 patients in 2019 and 2021, respectively. Regarding age, 31.1% were admitted before 28 days of age. LP gradually increased from 216 patients (30.9%) in 2019 to 239 patients (36.4%) in 2021. Thirty-three laparoscopic operations (4.8%) were converted to an open approach. In 24 of all patients, there was an injury to the stomach, in 20 patients to the duodenum, needing repair with sutures. Analysis of the quality reports indicated that 44% of pediatric surgical departments performed LP. Although LP has became more prevalent in Germany recently, about two thirds of patients still undergo an open procedure.

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Section: Discussionsupporting

confidence: 92%

Nationwide trends of laparoscopic pyloromyotomy in patients with infantile hypertrophic pyloric stenosis in Germany: A slow path forward

et al. 2023

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“…Further, Bhattacharyya et al found girls to have a reduced risk of postoperative bleeding after tonsillectomy [ 15 ]. On the opposite, female sex has been associated with worse postoperative outcomes after pyloromyotomy [ 16 ]. There may also be differences when it comes to seeking and receiving health care, though research in the pediatric field is sparse.…”

Section: Introductionmentioning

confidence: 99%

Sex differences in children operated with pyeloplasty for pelvoureteric junction obstruction

Högberg,

Värelä,

Anderberg

et al. 2023

Pediatr Surg Int

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Purpose Pelvoureteric junction obstruction (UPJO) is a common cause of hydronephrosis in children but no previous studies have evaluated differences between boys and girls operated with pyeloplasty. This study aimed to evaluate potential differences between sexes in children operated with pyeloplasty for PUJO in terms of presentation, surgery, and long-term results. Methods Data was retrospectively collected from all children operated on with pyeloplasty between January 2002 and December 2020. Data contained several variables covering presentation, surgery, and long-term results. Results In total, 194 patients were included of which 126 (64.9%) were boys. There were no significant differences in prenatal findings, pelvic dilation on ultrasound, function of the affected kidney, surgical method, obstruction type, resolution of hydronephrosis, or improvement of function. Boys presented with pain more often than girls (47.4 vs 25.0%, p < 0.01) while girls were more prone to infections preoperatively (17.2 vs 7.0%, p = 0.04). All nine patients requiring reoperation were boys (p = 0.03). Conclusion Girls with UPJO seem to experience infections as presenting symptoms more often than boys, while boys significantly more often present with pain. There is also a higher percentage of boys needing reoperation.

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“…Незважаючи на спроби медикаментозної терапії [11,24], пілороміотомія залишається основним методом лікування ГПС [2,10,16]. Тоді як інтраопераційні ускладнення і безпосередні результати пілороміотомії широко висвітлені в літературі [14,15,22], то віддалені наслідки цього втручання, особливо залежно від методу корекції, недостатньо вивчені та містять суперечливі результати [6,7,17,19].…”

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Remote consequences of pyloromyotomy in children

Malovanyy¹,

Pereyaslov²

2023

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Hypertrophic pylorostenosis is one of the most frequent causes of vomiting in newborns requiring surgical intervention. While the intraoperative complications and immediate results of pyloromyotomy are widely reported in the literature, the remote consequences of this intervention, especially depending on the method of correction, are not well understood and contain contradictory results. Purpose - to study the remote consequences of pyloromyotomy depending on the method of surgical correction - open (OMPT) or laparoscopic pyloromyotomy (LMPT). Materials and methods. The primary assessment of long-term outcomes was performed by analysing the answers to the questions of the Diagnostic Questionnaire for Paediatric Functional Gastrointestinal Disorders, which was sent to 246 patients and their parents; responses were received from 169 (68.7%) respondents, who were included in the study. Re-hospitalisation was required in 57 (33.7%) children who underwent X-ray examination, fibrogastroscopy and ultrasonography. Statistical processing of the study results was performed using the software StatPlus: mac, AnalystSoft Inc. (version v8). Results. The average age of patients involved in the study was 8.5±0.3 years (range of fluctuations - from 2 to 18 years old). Among the respondents, 132 (78.1%) children underwent OPMT, and 37 (21.9%) children underwent LPMT. No complaints were expressed by 102 (60.4%) children, including 81 (61.4%) children after OPMT and 21 (56.8%) after LPMT (p=0.6152). The main complaint in children after pyloromyotomy, which required re-hospitalisation, was chronic abdominal pain, as indicated by 38 (22.5%) of the respondents. There was no correlation between the occurrence of chronic abdominal pain and the age at which hypertrophic pylorostenosis was diagnosed (R=0.183, p=0.2588), the duration of the disease (R=0.079, p=0.6275) and the child's body weight at the time of the intervention (R=0.048, p=0.768). Functional disorders of the digestive tract were diagnosed in 15 (8.9%) children. In 24 (14.2%) children, a slowdown in barium passage through the intestine was detected, which, in combination with periodic pain, indicated chronic adhesive disease. Fibrogastroscopy revealed duodenogastric reflux in 18 (10.7%) children, which in 5 (2.96%) patients was combined with pylorus insufficiency and in 12 (7.1%) with gastritis, and in 17 (10.1%) children gastroesophageal reflux was diagnosed. Conclusions. Thus, in the long term after pyloromyotomy, 33.7% of children required re-hospitalisation due to various pathologies of the gastrointestinal tract. Duodenogastric and gastroesophageal reflux and chronic adhesive disease were most often detected in the long term after pyloromyotomy, and the frequency of their occurrence did not depend on the method of surgical intervention. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the institution mentioned in the paper. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

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Differences in Outcomes Based on Sex for Pediatric Patients Undergoing Pyloromyotomy

Cited by 5 publications

References 23 publications

Nationwide trends of laparoscopic pyloromyotomy in patients with infantile hypertrophic pyloric stenosis in Germany: A slow path forward

Nationwide trends of laparoscopic pyloromyotomy in patients with infantile hypertrophic pyloric stenosis in Germany: A slow path forward

Sex differences in children operated with pyeloplasty for pelvoureteric junction obstruction

Remote consequences of pyloromyotomy in children

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