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Umbilical incision for pyloromyotomy

G Podevin1, A Missirlu, S Branchereau

  • 1Service de Chirurgerie Viscérale Pédiatrique, Hôpital Armand Trousseau, Paris, France.

European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery ... [Et Al] = Zeitschrift Fur Kinderchirurgie
|February 1, 1997
PubMed
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The umbilical incision for hypertrophic pyloric stenosis surgery offers cosmetic benefits without increasing complications. This approach resulted in similar morbidity but shorter hospital stays compared to the standard right upper quadrant incision.

Area of Science:

  • Pediatric Surgery
  • Surgical Innovation
  • Gastrointestinal Surgery

Background:

  • Hypertrophic pyloric stenosis (HPS) surgery traditionally uses a right upper quadrant (RUQ) incision, leading to cosmetic concerns.
  • The umbilical incision (UMB) presents a novel approach to minimize visible scarring in HPS treatment.

Purpose of the Study:

  • To compare the morbidity associated with the umbilical incision versus the standard RUQ incision for HPS curative procedures.
  • To evaluate the safety and efficacy of the UMB approach in pediatric patients.

Main Methods:

  • Retrospective comparison of 118 children who underwent UMB surgery (1992-1994) with 121 children who had RUQ surgery (1989-1991).
  • Analysis of demographic data (age, sex, weight, prematurity) and surgical outcomes including operating time, mucosal perforations, postoperative vomiting, wound infections, relapses, and dehiscences.

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Main Results:

  • Mean operative times were significantly longer for the UMB group (52 min) compared to the RUQ group (38 min) (p < 0.001).
  • No significant differences in morbidity were observed between the UMB and RUQ groups, including mucosal perforations, early vomiting, wound infections, relapses, and dehiscences.
  • Postoperative hospital stays showed a trend towards being shorter in the UMB group.

Conclusions:

  • The umbilical incision is a viable alternative for pyloromyotomy, offering improved cosmesis without compromising patient safety or increasing complication rates.
  • Despite a slight increase in operative time, the UMB approach for HPS surgery results in minimal scarring and comparable morbidity to the traditional RUQ incision.