Ramstedt's pyloromyotomy--what is the correct incision?
OBJECTIVE
To retrospectively review Starship's complication rates of the vertical midline incision and transverse right upper quadrant incision in Ramstedt's pyloromyotomy.


METHODS
A retrospective chart and operation note review over a seven and a half year period of all infants having a Ramstedt's pyloromyotomy for infantile hypertrophic pyloric stenosis at Auckland Hospital.


RESULTS
Of 140 patients there were 117 transverse and 18 midline incisions (with 5 exclusions). No statistically significant differences were found between either group for wound, dehiscence, wound infection or incisional hernia. However, wound dehiscence occurred relatively more often in the midline group (2/18) than in the transverse group (3/117), although this did not reach statistical significance (Fisher exact test p-value = 0.15).


CONCLUSIONS
There is no convincing evidence that either incision is better than the other. There is a low number of wound complications occurring at Starship with Ramstedt's operation. Overall results compare favourably with both New Zealand and overseas institutions.
Hingston
G
G
Starship Children's Health, Auckland.
D006801:Humans; D006984:Hypertrophy / Q000601:surgery; D007231:Infant, Newborn; D007431:Intraoperative Complications / Q000453:epidemiology / Q000401:mortality; D011707:Pyloric Stenosis / Q000601:surgery*; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative / Q000379:methods