Umbilical pyloromyotomy: comparison of vertical linea alba and transverse muscle cutting incisions.
BACKGROUND
Pyloromyotomy is commonly performed through a supraumbilical skinfold incision. Entry into the peritoneal cavity can be achieved via a vertical linea alba incision or a transverse muscle cutting approach. The aim of this study was to compare the morbidity associated with these 2 operative techniques.


METHODS
Case records of all babies undergoing umbilical pyloromyotomy between January 2000 and December 2004 were retrospectively compared for postoperative dehiscence, mucosal perforation, and wound infection (defined by the need for antibiotics or wound exploration). Data were analyzed with GraphPad Prism contingency tables and results were compared by Fisher exact test (P < .05).


RESULTS
During the study period, 341 umbilical pyloromyotomies were performed at our institution. The surgeon was permitted choice of either operative approach (219 vertical linea alba, and 122 transverse muscle cutting). There were no significant differences between the 2 groups regarding age at presentation, sex, duration of symptoms, biochemical derangement, and operator seniority. No significant differences in morbidity were encountered with either of these 2 operative strategies.


CONCLUSIONS
This study demonstrates that the vertical linea alba and transverse muscle cutting incisions have equivalent postoperative morbidity. These findings indicate that neither technique is demonstrably superior.
Mullassery
Dhanya
D
Department of Paediatric Surgery, The Royal Liverpool Children's Hospital (Alder Hey), The University of Liverpool, UK. drdhanyauk@hotmail.com
Shariff
Raheel
R
Craigie
Ross J
RJ
Losty
Paul D
PD
Kenny
Simon E
SE
Baillie
Colin T
CT
D034861:Abdominal Wall / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D046248:Pyloric Stenosis, Hypertrophic / Q000601:surgery*; D012189:Retrospective Studies