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[Hypertrophic pyloric stenosis in infants: laparoscopic pyloromyotomy]
W L Kramer1, J D van der Bilt, N M Bax
1Universitair Medisch Centrum, locatie Wilhelmina Kinderziekenhuis, divisie Heelkunde, afd. Kinderchirurgie, Postbus 85.090, 3508 AB Utrecht. w.kramer@wkz.azu.nl
Objective:
To evaluate the results of laparoscopic pyloromyotomy in infants with hypertrophic pyloric stenosis (HPS).
Design:
Retrospective.
Method:
Data from medical records were collected on all children who underwent laparoscopic extramucosal pyloromyotomy for hypertrophic pyloric stenosis in the period from 1 October 1993 to 31 March 2001 in the Wilhelmina Children's Hospital of the Utrecht University Medical Centre, the Netherlands.
Results:
A total of 133 children were operated: 108 boys (81%) and 25 girls (19%). The mean age on the day of operation was 35.3 days (SD: 15.4). Of these children, 17 (13%) were ex-prematures and 8 (6%) were ex-dysmatures, and 40 (30%) had a positive family history for HPS. The mean operating time was 29 min (SD: 10); per surgeon, the first 5 operations required over 30 minutes on average and the following operations lasted an average of 26 minutes. Postoperatively, 84 patients (63%) no longer vomited. Four children required a second operation. The mean period from operation to discharge was 61.6 hours (SD: 46.0). Complications included: perforations of the mucosa (n = 4; 3%), wound infections (n = 4; 3%) and small incisional hernias (n = 5; 4%).
Conclusion:
Laparoscopic pyloromyotomy is an efficient and safe operative technique for the treatment of infants with HPS.