Retrospective comparison of open versus laparoscopic pyloromyotomy.
BACKGROUND
Laparoscopic pyloromyotomy is gaining popularity in the management of pyloric stenosis. However, there is no unequivocal evidence in favour of the laparoscopic over the open approach. This paper reports an experience with laparoscopic pyloromyotomy and an attempt to identify any benefit over the open procedure.


METHODS
This was a retrospective review of all 87 pyloromyotomies performed at this institution for pyloric stenosis over the 39 months since the first laparoscopic pyloromyotomy was performed.


RESULTS
Data for 39 infants who underwent laparoscopic pyloromyotomy were compared with those for 38 infants who underwent pyloromyotomy via a periumbilical incision. Patient demographics were similar between the two groups. The duration of operation was longer for laparoscopic pyloromyotomy than for the open procedure (median 50 versus 30 min; P = 0.001). There were no differences in recovery time, postoperative length of hospital stay, complication rates and postoperative analgesia requirements between the two groups.


CONCLUSIONS
Laparoscopic pyloromyotomy has been incorporated successfully into the authors' standard working practice. Complication rates recovery times were similar to those achievable with the open procedure. There was no clear benefit of one approach over the other.
Hall
N J
NJ
Department of Paediatric Surgery, Institute of Child Health and Great Ormond Street Hospital for Children NHS Trust, 30 Guilford Street, London WC1N 1EH, UK.
Ade-Ajayi
N
N
Al-Roubaie
J
J
Curry
J
J
Kiely
E M
EM
Pierro
A
A
D000698:Analgesia; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D010149:Postoperative Pain / Q000517:prevention & control; D011182:Postoperative Care / Q000379:methods; D011707:Pyloric Stenosis / Q000601:surgery*; D011708:Pylorus / Q000601:surgery*; D012189:Retrospective Studies