Laparoscopic versus open pyloromyotomy in cases of infantile hypertrophic pyloric stenosis / Ahmed Ezzat Abdelnabi Arafat ; Supervised Gamal Eltagy , Khaled Hussein , Mahmoud Elfiky

Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of General Surgery

Aim: To analyze our experience with laparoscopic pyloromyotomy for IHPS and the lessons that we learnt. Materials and Methods: This is a prospective analysis of case records of 50 infants of whom 25 cases underwent laparoscopic pyloromyotomy and the rest underwent open pyloromyotomy through right upper quadrant incision in the period between January and august 2015. The demographic characteristics, conversion rate, operative time, complications, time to first feed and post-operative hospital stay were noted. The above parameters were compared between the two groups. Results: 35 male and 15 female babies ranging in age from 20 days to 62 days (mean ± 1SD) of 29 to 52 days were operated upon during this period. One case in the group underwent laparoscopic pyloromyotomy was converted to open (4%): due to mucosal perforation. The mean operative time of laparoscopic pyloromyotomy was 19.5 ± 8.27 minutes while the mean operative time of the open approach was 14.6 ± 2.79 minutes with the P value = 0.024. There were 2 complications among the group underwent laparoscopic pyloromyotomy; 1 mucosal perforation and 1 inadequate pyloromyotomy. There was a case that had wound site infection among the group underwent open pyloromyotomy. All the complications were effectively handled with minimum morbidity. Oral feeding was started regularly for all patients 6 hours postoperatively.Infants achieved full feeding within 18 hours to 30 hours with a mean of 20.56 hours for the laparoscopic approach and within 18 to 36 hours with a mean of 21.76 hours for the open approach

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