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KMID : 1035920160190010009
Journal of Minimally Invasive Surgery
2016 Volume.19 No. 1 p.9 ~ p.13
Outcomes of Laparoscopic Pyloromyotomy with Microscope and Stab Incision vs. Open Pyloromyotomy in Infantile Hypertrophic Pyloric Stenosis; Single Institution Experience
:Kim Tae-ah
:Sung Tae-Yon/:Kang Won-Me/:Ahn Soo-Min
Abstract
Purpose : We attempted to evaluate the outcomes of a newly inaugurated surgical technique of laparoscopic pyloromyotomy with microscope and stab incision (MS-LP) with right upper quadrant transverse open pyloromyotomy (RT-OP), which were performed in a single institution.

Methods : The outcome variables in terms of total anesthesia time, operative time, postoperative emesis, time to full-enteral feeding, postoperative hospital stay, cosmetic result score, medical cost, and postoperative wound complications were compared between the MS-LP and RT-OP groups.

Results : Fifty-one consecutive pyloromyotomy cases were enrolled; MS-LP (n=33) and RT-OP (n=18). There was no difference in age, pyloric thickness, and preoperative electrolyte levels between the two groups. The total anesthesia time and operative time of MS-LP were not significantly longer than that of RT-OP. Time to full-enteral feeding and postoperative hospital stay were shorter in MS-LP (20.0¡¾18.3 vs. 35.3¡¾14.8 hrs. and 2.4¡¾1.3 vs. 3.4¡¾1.2 days; p=0.047 and 0.050, respectively). The cosmetic result score and medical cost were significantly higher in MS-LP (9.1¡¾1.0 vs. 7.3¡¾1.2 in terms of scores and 3,501,950¡¾1,093,147 vs. 2,522,474¡¾68,605 in terms of KRW; p=0.001 and 0.021, respectively). No difference in postoperative wound complications was observed between the two groups.

Conclusion : Laparoscopic pyloromyotomy with microscope and stab incision may suggest recovery benefits with a shorter time to full-enteral feeding and postoperative hospital stay, as well as better cosmetic results than RT-OP. However, MS-LP may induce higher costs.
KEYWORD
Laparoscopic, Pyloromyotomy, Microscope, Infantile hypertrophic pyloric stenosis
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