Laparoscopic pyloromyotomy for hypertrophic pyloric stenosis: a survey of 407 children

Binet, Aurélien; Klipfel, C.; Meignan, Pierre; Bastard, François; Cook, Ann-Rose; Braik, Karim; Touze, A. Le; Villemagne, T.; Robert, M.; Ballouhey, Quentin; Lengelle, Francois; Amar, S.; Lardy, H.

doi:10.1007/s00383-018-4235-3

Cited by 14 publications

(12 citation statements)

References 43 publications

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“…Laparoscopic pyloromyotomy resulted in less post-operative pain and better cosmetic outcome and parents' satisfaction in the current study. Similar conclusions reported by Rumsey and Harcourt (23) and Binet et al (5). St Peter et al (24) evaluated the cosmetic outcome in more objective manner by asking the parents to complete a validated Patient Scar Assessment Questionnaire with photos.…”

Section: Discussionmentioning

confidence: 60%

“…Binet et al (5) noted that the operative time significantly affected the time needed to reach full feeding (P = 0.006). In this study, LP was found to be followed by shorter time to reach full feeding, less post-operative emesis, and shorter hospital stay.…”

Section: Discussionmentioning

confidence: 99%

“…Laparoscopic pyloromyotomy was expected to add the advantages of the minimal invasive surgery resulting in faster recovery, shorter hospital stay, and better cosmetic outcome when compared with open pyloromyotomy (OP) (4,5). Conversely, it was unclear whether the use of laparoscopy may lead to a higher complications rate and exposure to possible side effects of carbon dioxide insufflation in infants (6,7).…”

Section: Introductionmentioning

confidence: 99%

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Laparoscopic vs. Open Pyloromyotomy in Treatment of Infantile Hypertrophic Pyloric Stenosis

et al. 2020

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Background/Purpose: Laparoscopic pyloromyotomy gained wide popularity in management of pyloric stenosis with contradictory results regarding its benefits over classic open approach. This study aimed at comparing both regarding their safety, efficiency, and outcome. Methods: This is a prospective randomized controlled study performed from April 2017 to April 2019. It included 80 patients, divided randomly into two groups, where laparoscopic pyloromyotomy was performed in group A and open pyloromyotomy in group B. Both groups were compared regarding operative time, post-operative pain score, time required to reach full feeding, hospital stay, complications, and parents' satisfaction. Results: Median operative time was 21 min in group A vs. 30 min in group B (P = 0). Pain Assessment in Neonates scores were generally higher in group B with more doses of analgesics required (P = 0). Mean time needed to reach full feeding was 15.2 and 18.8 h in groups A and B, respectively (P = 0). Median hospital stay was 19 h in group A and 22 h in group B (P = 0.004). Parents' satisfaction also was in favor of group A (P = 0.045). Although no significant difference was reported between both groups regarding early and late complications, some complications such as mucosal perforation and incomplete pyloromyotomy occurred in the laparoscopic group only. Conclusion: Laparoscopic pyloromyotomy was found superior to open approach regarding faster operative time, less need of analgesics, easier development of oral feeding, shorter hospital stay, and better parents' satisfaction. Yet, there are still some concerns about the safety and efficiency of this procedure over open technique.

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Section: Discussionmentioning

confidence: 60%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Laparoscopic vs. Open Pyloromyotomy in Treatment of Infantile Hypertrophic Pyloric Stenosis

et al. 2020

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“…У 2018 р. A. Binet зі співавторами відмітили, що тривалість хірургічного втручання впливає на час початку ентерального харчування [6]. За результатами нашого дослідження, ентеральне харчування розпочинали раніше після лапароскопічного втручання, хоча його тривалість була більшою порівняно з традиційною пілороміотомією (табл.…”

Section: результати дослідження та їх обговоренняunclassified

Choice of method of the treatment in newborns with hypertrophic pyloric stenosis

Pereyaslov¹,

Malovanyy²,

Stenyk³

et al. 2021

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Hypertrophic pyloric stenosis (HPS) remains the main cause of projectile vomiting in newborns. During many decades the open pyloromyotomy was the main method of treatment in children with HPS due to the excellent results and low frequency of complications. After applying the laparoscopic pyloromyotomy, this approach gradually became accepted by pediatric surgeons. Regarding advantages and disadvantages of laparoscopic pyloromyotomy compared to conventional pyloromyotomy the literature data had a contradictory character. The aim is to analyze our own experience in the treatment of children with HPS using traditional and minimally invasive techniques. Materials and methods. This study based on the results of the treatment of 98 children, which were operated with pyloric stenosis during 2009–2020 years. Diagnosis was established on the results of clinical, laboratory investigation, and ultrasonographic data. Surgery was applied after correction of electrolytes disturbances, but a type of approach (open or laparoscopic) was chosen by surgeon. With the aim to evaluate the results the methods of variative statistic, parametric and nonparametric evaluation were applied. Results. Open pyloromyotomy was applied in 76 (77.6%) and laparoscopic – in 22 (22.4%) of children. Complications developed in 10 children, including 8 (10.5%) patients after open and 2 (9.1%) – after laparoscopic pyloromyotomy (p=0.842). Perforation of mucosa was in one (4.55%) child during laparoscopic pyloromyotomy, but in case of open approach this complication was absent. Independence of the approach, the cases of incomplete myotomy were absent. The surgical site infection (3.95%), postoperative hernia (2.63%), and adhesive bowel obstruction (2.63%) were more often observed after open pyloromyotomy. Laparoscopic pyloromyotomy characterized by the decrease of terms of starting enteral feeding (p<0.001) and length of hospital stay (p=0.031) compared with open pyloromyotomy. Conclusions. Pyloromyotomy remains the main method of treatment of newborns with pyloric stenosis, but a type of approach was chosen by surgeon. Open and laparoscopic pyloromyotomy equally effective and safe for the treatment of children with the hypertrophic pyloric stenosis. The research was carried out in accordance with the principles of the Helsinki declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: hypertrophic pyloric stenosis, newborns, treatment, pyloromyotomy, laparoscopy.

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“…Finally, the gastric mucosa bulges upward into the incision. Historically, PM was performed under laparotomy, but it was adapted to laparoscopy [10][11][12][13]. Recently, new and less invasive methods have been described, including a report stating that gastric per-oral endoscopic PM was a useful and safe method [14][15][16][17].…”

Section: Surgical Pyloric Proceduresmentioning

confidence: 99%

The Optimal Pyloric Procedure: A Collective Review

Kim

2020

Korean J Thorac Cardiovasc Surg

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Vagal damage and subsequent pyloric denervation inevitably occur during esophagectomy, potentially leading to delayed gastric emptying (DGE). The choice of an optimal pyloric procedure to overcome DGE is important, as such procedures can lead to prolonged surgery, shortening of the conduit, disruption of the blood supply, and gastric dumping/bile reflux. This study investigated various pyloric methods and analyzed comparative studies in order to determine the optimal pyloric procedure. Surgical procedures for the pylorus include pyloromyotomy, pyloroplasty, or digital fracture. Botulinum toxin injection, endoscopic balloon dilatation, and erythromycin are non-surgical procedures. The scope, technique, and effects of these procedures are changing due to advances in minimally invasive surgery and postoperative interventions. Some comparative studies have shown that pyloric procedures are helpful for DGE, while others have argued that it is difficult to reach an objective conclusion because of the variety of definitions of DGE and evaluation methods. In conclusion, recent advances in interventional technology and minimally invasive surgery have led to questions regarding the practice of pyloric procedures. However, many clinicians still perform them and they are at least somewhat effective. To provide guidance on the optimal pyloric procedure, DGE should first be defined clearly, and a large-scale study with an objective evaluation method will then be required.

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Laparoscopic pyloromyotomy for hypertrophic pyloric stenosis: a survey of 407 children

Cited by 14 publications

References 43 publications

Laparoscopic vs. Open Pyloromyotomy in Treatment of Infantile Hypertrophic Pyloric Stenosis

Laparoscopic vs. Open Pyloromyotomy in Treatment of Infantile Hypertrophic Pyloric Stenosis

Choice of method of the treatment in newborns with hypertrophic pyloric stenosis

The Optimal Pyloric Procedure: A Collective Review

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