A 9-Year Single Center Experience with Circumumbilical Ramstedt's Pyloromyotomy

Abstract

Introduction: Pyloric stenosis is a common cause of vomiting in infancy and is usually treated with a Ramstedt's pyloromyotomy. In this study we retrospectively reviewed our experience with the circumumbilical incision for the treatment of pyloric stenosis with a particular emphasis on the relation between postoperative emesis and postoperative time to feeds.

Material and Method: The medical records of all patients undergoing pyloromyotomy for IHPS from January 2000 to December 2008 were reviewed retrospectively. Patient details were recorded and statistically analyzed using SPSS version 13. We reviewed our experience looking specifically at the postoperative time to initial feeds as a way of minimizing hospital stay.

Results: 513 patients’ notes were available for the study. There were 440 males and 73 females (M:F ratio 6:1). Median age at operation was 40 days (2–194 days) and a positive family history was obtained in 11.9%. Median duration of symptoms was 10 days (range 1–60 days). There were 31 (6%) complications related to surgery. The average number of postoperative emesis episodes was 1.9. The median postoperative hospital stay was 2 days (1–60). The average time to feeding was 20 h (1–69).

Conclusion: This is a large single-center retrospective study where, in the era of minimally invasive surgery, Ramstedt's pyloromyotomy via the circumumbilical approach has a low rate of complications and is a safe and feasible method to treat pyloric stenosis. The establishment of feeds soon after surgery minimizes the postoperative in-hospital stay.

Key words

pyloric stenosis - pyloromyotomy - circumumbilical

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Correspondence