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Circumumbilical pyloromyotomy in the era of minimally invasive surgery
Denis A Cozzi1, Silvia Ceccanti, Ermelinda Mele
1Pediatric Surgery Unit, University of Rome La Sapienza, Azienda Policlinico Umberto I, Rome, RM 00161, Italy. da.cozzi@uniroma1.it
Insights
Parents are highly satisfied with the cosmetic results of circumumbilical pyloromyotomy for infantile hypertrophic pyloric stenosis. The surgical scar is consistently rated as excellent or good by families and medical staff.
Area of Science:
- Pediatric Surgery
- Surgical Outcomes
- Cosmetic Surgery
Background:
- Limited research exists on the cosmetic outcomes of infant pyloromyotomy.
- Hypertrophic pyloric stenosis (HPS) requires surgical intervention.
Purpose of the Study:
- To evaluate the final scar appearance after circumumbilical pyloromyotomy in infants.
- Assess patient and family satisfaction with the cosmetic results.
Main Methods:
- A 16-year retrospective study of 86 infants undergoing circumumbilical pyloromyotomy.
- Family perceptions collected via questionnaires and interviews.
- Blind assessment of scar cosmesis by 5 staff members using photographs and a rating scale.
Main Results:
- 100% of surveyed families reported excellent or good scar appearance.
- 90% of scars were rated excellent or good by independent assessors.
- High intra- and interobserver agreement (0.72 and 0.78) for scar assessment.
Conclusions:
- Circumumbilical pyloromyotomy yields highly satisfactory cosmetic outcomes.
- The surgical approach is well-accepted aesthetically by families and clinicians.
Background/Purpose:
No studies have investigated the cosmetic outcome of current approaches to pyloromyotomy in infants with hypertrophic pyloric stenosis. The purpose of this study was to evaluate the final appearance of the scar in patients undergoing circumumbilical pyloromyotomy.
Methods:
During a 16-year period, 86 infants underwent circumumbilical pyloromyotomy at our institution. A detailed questionnaire was created to document the family members' perceptions of the esthetic appearance of the scar. Data were collected by telephone interview and at clinic visit. In addition, cosmesis was assessed by 5 staff members who scored blindly the esthetic outcome of the scars with comparative photographs, using a categorical scale.
Results:
Fifty-seven families were tracked by telephone contact. In the family questionnaire, 100% of families reported an excellent or good scar. Of these, forty-one (72%) were available for cosmetic assessment. Follow-up ranged between 5 months and 15 years (mean, 6 years). The panel members ranked the scar, on average, as excellent or good for 90% of the patients. No assessor stated that a scar was unacceptable. Intra- and interobserver agreement was 0.72 and 0.78, respectively.
Conclusions:
Overall satisfaction with the cosmetic outcome of circumumbilical pyloromyotomy is very high.
