title: Circumumbilical pyloromyotomy: larger pyloric tumours need an extended incision.
abstract: Circumumbilical pyloromyotomy has been used widely to offer an optimum cosmetic approach. On occasion, there are difficulties in delivering the large pyloric tumour through a relatively small incision. The authors prospectively collected a series of 39 consecutive pyloromyotomies performed over a period of 3 years in three teaching hospitals. Patients were aged 13 to 90 days (average 35) and the male-female ratio was 5:1. The initial operative approach was a right upper quadrant (RUQ) incision (n = 6) and later a circumumbilical incision (CUI), with or without lateral extension, combined with transverse division of the linea alba and part of both rectus muscles (n = 33). Two infants (1 RUQ and 1 CUI) developed wound infections, which were treated with antibiotics. There were no other peri- or postoperative complications. It was necessary to extend the incision in one-third of CUI cases (n = 12) in order to facilitate the delivery of a large pyloric tumour through the incision. Both omega-shaped (n = 3) and a new modified extension (n = 9) have been used with good cosmetic results.
authors.affiliation: Department of Surgery, King Khalid University Hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia. arkhan@ksu.edu.sa
authors.forename: A R
authors.initials: AR
authors.lastname: Khan
authors.forename: A R
authors.initials: AR
authors.lastname: Al-Bassam
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007813:Laparotomy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D011446:Prospective Studies; D011708:Pylorus; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000601:surgery*; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000209:etiology; D016896:Treatment Outcome; D014472:Umbilicus / Q000601:surgery*
chemical_list: D000900:Anti-Bacterial Agents