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Ad libitum feeds after laparoscopic pyloromyotomy: a retrospective comparison with a standardized feeding regimen in

Obinna O Adibe1, Peter F Nichol, Foong-Yen Lim

  • 1General, Thoracic, and Fetal Surgery, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
|May 9, 2007
PubMed

Insights

Ad libitum feeding is as effective as standardized feeding after laparoscopic pyloromyotomy for hypertrophic pyloric stenosis. Infants fed ad libitum reach full feeds faster without increased postoperative emesis or hospital stay.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Infant Nutrition

Background:

  • Postoperative feeding regimens after pyloromyotomy for hypertrophic pyloric stenosis are debated.
  • Key concerns include postoperative emesis and hospital length of stay.

Purpose of the Study:

  • To compare outcomes of infants fed via a standardized regimen versus ad libitum after laparoscopic pyloromyotomy.
  • To evaluate postoperative emesis and length of hospital stay.

Main Methods:

  • Retrospective review of 227 infants undergoing laparoscopic pyloromyotomy.
  • Comparison of two groups: standardized feeding regimen vs. ad libitum feeding.
  • Analysis of postoperative emesis frequency, time to full feeds, and hospital stay duration.

Main Results:

  • Infants fed ad libitum reached full feeds significantly faster (19.0 vs. 23.1 hours; P < 0.01).
  • No significant differences were observed in postoperative emesis (1.8 vs. 1.9 times/patient) or hospital stay (49.0 vs. 50.3 hours).
  • No complications occurred in either feeding group.

Conclusions:

  • A standardized feeding regimen provides no advantage over ad libitum feeding post-laparoscopic pyloromyotomy.
  • Ad libitum feeding allows faster advancement to full feeds without increasing emesis.
  • Ad libitum feeding is now the standard postoperative regimen at the institution.
Abstract

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