title: Laparoscopic pyloromyotomy is both safe and effective in a district hospital.
abstract: BACKGROUND
  Functional operations of the gastrointestinal tract are ideal indications for minimal-access surgery. The aim of this paper was to assess the safety and potential benefits of the laparoscopic Ramstedt pyloromyotomy using the experience of a single surgeon in a district general hospital.
  
  
  METHODS
  90 consecutive infants underwent pyloromyotomy: 35 open procedures and 55 laparoscopic procedures. This is a retrospective study but the operative data of the laparoscopic group were collected prospectively.
  
  
  RESULTS
  There were no differences in demographic data between the groups. The open group had a shorter mean operating time, 22.14 min, than the laparoscopic group, 26.04 min (p = 0.022). There was no significant difference in the time to full feed between the two groups (p = 0.076). 62.9% of the infants in the open group vomited compared with only 43.4% in the laparoscopic group (p = 0.058). The laparoscopic group had shorter postoperative stay, 62.33 hours, compared to 91.89 hours (p = 0.001). There was one reoperation in each group: for complete wound dehiscence in the open group and for incomplete myotomy in the laparoscopic group.
  
  
  CONCLUSIONS
  Laparoscopic pyloromyotomy (LPM) is as safe as the open procedure and has the potential benefits of shorter hospital stay and improved cosmesis.
authors.affiliation: Upper GI Surgery, The Princess Royal Hospital, Telford, Shropshire, United Kingdom. abdulmajidali@hotmail.com
authors.forename: Abdulmajid
authors.initials: A
authors.lastname: Ali
authors.forename: Gopi
authors.initials: G
authors.lastname: Tripuraneni
authors.forename: Subramanian
authors.initials: S
authors.lastname: Velmurugan
authors.forename: Audun
authors.initials: A
authors.lastname: Sigurdsson
authors.forename: John
authors.initials: J
authors.lastname: Lotz
mesh_terms: D016009:Chi-Square Distribution; D015331:Cohort Studies; D013505:Digestive System Surgical Procedures / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010535:Laparoscopy / Q000379:methods*; D007813:Laparotomy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D011336:Probability; D046248:Pyloric Stenosis, Hypertrophic / Q000175:diagnosis / Q000601:surgery*; D011708:Pylorus / Q000601:surgery*; D012189:Retrospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D016896:Treatment Outcome