Ramstedt's pyloromyotomy: a specialist procedure?
One hundred and twenty infants with infantile hypertrophic pyloric stenosis were operated on by two consultant general surgeons over a 13-year period. General anaesthetic and a standard surgical approach was used in all cases. No mortality was recorded and there were no wound dehiscences. The overall postoperative wound infection rate was 9.2%. Prior to 1985 the infection rate was 15%. Following attention to a number of details including care of the umbilicus, the incidence decreased after 1985 to 4%. The most common postoperative complication was vomiting, which occurred in 25% of infants. There was one negative laparotomy in the 13-year study period. Two children required a second procedure for persistent vomiting. The argument in favour of specialisation in managing this condition is questioned along with the need for intensive diagnostic investigation.
O'Donoghue
J M
JM
Department of Surgery, Portiuncula Hospital, Ballinasloe, Co. Galway, Ireland.
O'Hanlon
D M
DM
Gallagher
M M
MM
Connolly
K D
KD
Doyle
J
J
Flynn
J R
JR
D005260:Female; D006801:Humans; D006984:Hypertrophy / Q000601:surgery; D007223:Infant; D007431:Intraoperative Complications; D008297:Male; D011707:Pyloric Stenosis / Q000601:surgery*; D011708:Pylorus / Q000601:surgery; D013038:Specialization; D013530:Surgical Wound Infection