Outcomes During a Transition Period from Open to Laparoscopic Pyloromyotomy
| Autor: | Nabil Hussein, Haitham Dagash, Lucy Henderson, Nitin Patwardhan |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Incisional hernia medicine.medical_treatment Operative Time Pyloromyotomy Pyloric Stenosis Pyloric stenosis 03 medical and health sciences 0302 clinical medicine medicine Humans Incisional Hernia Surgical Wound Infection Statistical analysis Laparoscopy Acetaminophen Retrospective Studies Pain Postoperative medicine.diagnostic_test business.industry Infant Retrospective cohort study Analgesics Non-Narcotic medicine.disease Surgery Treatment Outcome 030220 oncology & carcinogenesis Female 030211 gastroenterology & hepatology Case note business Laparoscopic pyloromyotomy Learning Curve |
| Zdroj: | Journal of Laparoendoscopic & Advanced Surgical Techniques. 28:481-485 |
| ISSN: | 1557-9034 1092-6429 |
| DOI: | 10.1089/lap.2017.0366 |
| Popis: | Previous studies suggest that laparosopic pyloromyotomy may have some benefits over an open approach. We examined our results during a transition period from open to laparoscopic pyloromyotomy to see whether these benefits are sustained during the learning curve.This is a retrospective case note review of all patients undergoing pyloromyotomy at a tertiary institution for a 5-year period (2010-2015). Data are presented as median (range). Statistical analysis was performed with Fisher's exact and Student's t-test.A total of 185 pyloromyotomies were performed, with data available for 90 open and 60 laparoscopic procedures. Duration of surgery was 42 (16-102) minutes for open and 28 (14-97) minutes for laparoscopic procedures (P = .0001). Total paracetamol requirements were 23.5 (0-169.4) mg/kg for open and 13.9 (0-95.3) mg/kg for laparoscopic cases (P = .008). No postoperative analgesia was required for 23 open and 29 laparoscopic patients (P = .005). Complications in the open group included incomplete pyloromyotomy (n = 1) and wound infection (n = 4); complications in the laparoscopic group included incisional hernia (n = 1), omental port-site herniation (n = 2), and suspected perforation with conversion to open procedure, although no perforation was found (n = 1; P = 1.000).Our results suggest that when the laparoscopic technique is first introduced, overall complication rates are not statistically higher, and operative times and analgesia requirements are significantly shorter, despite the learning curve. |
| Databáze: | OpenAIRE |
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