Long-term Gastrointestinal Sequelae in Children who Underwent Pyloromyotomy for Infantile Hypertrophic Pyloric Stenosis.

Autor: van den Bunder FAIM; Department of Pediatric Surgery, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam and Vrije Universiteit Amsterdam, the Netherlands; Amsterdam Gastroenterology Endocrinology Metabolism, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam UMC, Amsterdam Reproduction and Development Research Institute, University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands. Electronic address: f.a.vandenbunder@amsterdamumc.nl., Pijpers AGH; Department of Pediatric Surgery, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam and Vrije Universiteit Amsterdam, the Netherlands; Amsterdam Gastroenterology Endocrinology Metabolism, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam UMC, Amsterdam Reproduction and Development Research Institute, University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands., van Heurn LWE; Department of Pediatric Surgery, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam and Vrije Universiteit Amsterdam, the Netherlands; Amsterdam Gastroenterology Endocrinology Metabolism, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam UMC, Amsterdam Reproduction and Development Research Institute, University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands., Koppen IJN; Amsterdam Gastroenterology Endocrinology Metabolism, Meibergdreef 9, Amsterdam, the Netherlands; Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, the Netherlands., Derikx JPM; Department of Pediatric Surgery, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam and Vrije Universiteit Amsterdam, the Netherlands; Amsterdam Gastroenterology Endocrinology Metabolism, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam UMC, Amsterdam Reproduction and Development Research Institute, University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.
Jazyk: angličtina
Zdroj: Journal of pediatric surgery [J Pediatr Surg] 2024 Nov 19; Vol. 60 (2), pp. 162073. Date of Electronic Publication: 2024 Nov 19.
DOI: 10.1016/j.jpedsurg.2024.162073
Abstrakt: Aim: Pyloromyotomy, the treatment for infantile hypertrophic pyloric stenosis (IHPS), is a procedure with a low risk of short-term complications and quick recovery. However, at a later age, some children report gastrointestinal (GI) symptoms and recently we described a fatal case of adhesive small bowel obstruction years after pyloromyotomy. Therefore, the aim of this study was to evaluate long-term gastrointestinal sequelae of pyloromyotomy.
Methods: All children who underwent open or laparoscopic pyloromyotomy between 2007 and 2017 (n = 450), were invited to complete a questionnaire, which included the Pediatric Quality of Life Inventory™ Gastrointestinal symptoms module (PedsQL™ GI Module). Outcomes were compared to published healthy controls (n = 587) and between surgical approach by using an unpaired t-test.
Results: In total, 199 respondents completed the questionnaire. The majority (n = 172, 86.4 %) was male with a mean age of 11.4 (±3.1) years. Laparoscopic pyloromyotomy was performed in 104 children (52.3 %) and open pyloromyotomy in 95 (47.7 %). The PedsQL™ GI Module mean total score of all children who underwent pyloromyotomy was 88.6 (±11.0), which is comparable to healthy controls (88.6 (±12.9)). All subtopics were similar for children who underwent pyloromyotomy compared to healthy controls. There were no differences in scores of the PedsQL™ GI module between the open and laparoscopic subgroup.
Conclusions: The scores of the PedsQL™ GI module do not differ between children who underwent pyloromyotomy during infancy and healthy controls. Therefore long-term gastrointestinal sequelae of pyloromyotomy appear to be an exception. This evidence can be used during parental counseling. It also suggests that there is no need for long-term follow-up.
Competing Interests: Conflicts of interest The authors have no conflicts of interest relevant to this article to disclose.
(Copyright © 2024. Published by Elsevier Inc.)
Databáze: MEDLINE
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