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Hypertrophic pyloric stenosis

Arun Kelay, Nigel J Hall
Pyloromyotomy is the tried and tested surgical procedure for successful operative treatment of pyloric stenosis. Over time, the operative approach has evolved to take advantage of cosmetically superior incisions and more recently minimally invasive surgery. During and following surgery, complications are uncommon. The specific complications of an inadequate pyloromyotomy requiring repeated procedure and mucosal perforation during an overzealous pyloromyotomy represent the ends of a spectrum within which sits the perfect procedure...
March 6, 2018: European Journal of Pediatric Surgery
Caitlyn M Costanzo, Charles Vinocur, Loren Berman
BACKGROUND: Hypertrophic pyloric stenosis (HPS) is one of the most common indications for non-elective surgery in the neonatal population. Multiple small prospective trials have shown that postoperative outcomes for laparoscopic versus open pyloromyotomy are equivalent or slightly better with the minimally invasive approach. This study uses a prospective national database to compare postoperative complications and length of stay for infants undergoing laparoscopic versus open pyloromyotomy...
April 2018: Journal of Surgical Research
Andrew Williams, Morgan McWilliam, James Ahlin, Jacob Davidson, Mackenzie A Quantz, Andreana Bütter
BACKGROUND: Hypertrophic pyloric stenosis (HPS) is a common neonatal condition treated with open or laparoscopic pyloromyotomy. 3D-printed organs offer realistic simulations to practice surgical techniques. The purpose of this study was to validate a 3D HPS stomach model and assess model reliability and surgical realism. METHODS: Medical students, general surgery residents, and adult and pediatric general surgeons were recruited from a single center. Participants were videotaped three times performing a laparoscopic pyloromyotomy using box trainers and 3D-printed stomachs...
February 8, 2018: Journal of Pediatric Surgery
Aurélien Binet, C Klipfel, P Meignan, F Bastard, A R Cook, K Braïk, A Le Touze, T Villemagne, M Robert, Q Ballouhey, F Lengelle, S Amar, H Lardy
INTRODUCTION: Pyloromyotomy is the standard care for hypertrophic pyloric stenosis. The traditional approach for this procedure is a right upper quadrant transverse incision, although other "open" approaches, such as circumumbilical or periumbilical incision have been described. The more recent approach used is laparoscopic pyloromyotomy (LP), but experience feedback is still debated and its benefits remain unproven. The aim of this study was to make a review of all our LP procedures with an objective evaluation according to the literature...
February 6, 2018: Pediatric Surgery International
William C Kethman, Alex H S Harris, Mary T Hawn, James K Wall
BACKGROUND: Hypertrophic pyloric stenosis (HPS) is one of the most common pediatric illnesses necessitating surgical intervention. Controversy remains over the optimal surgical approach between laparoscopic pyloromyotomy (LP) and open pyloromyotomy (OP). LP has gained acceptance for management of HPS in an era of expanding minimal access surgical approaches to pediatric conditions. Several studies suggest advantages of LP over OP; however, selection bias and small sample sizes remain a concern...
January 16, 2018: Surgical Endoscopy
Rene Ndongo, Paul Nkemtendong Tolefac, Faustin Félicien Mouafo Tambo, Matin Hongieh Abanda, Marcelin Ngowe Ngowe, Olivier Fola, Bonaventure Dzekem, Patrick Eroyl Weledji, Maurice Aurelien Sosso, Jacqueline Ze Minkande
OBJECTIVE: This study aimed to describe the clinical characteristics of patients with infantile hypertrophic stenosis, management and its outcome in two tertiary care centres in Cameroon. RESULTS: A total of 21 patients were included from the two centres. The mean age at presentation was 5.2 ± 1.2 weeks, predominantly male with a male-to-female ratio of 4.25:1. The triad of vomiting, visible peristalsis and palpable mass was present in only 7 (33.3%) of the participants...
January 16, 2018: BMC Research Notes
Bruno Martinez-Leo, Luis M Garcia-Cabello
A 23-day-old male infant was brought to the emergency department because of nonbilious vomiting that had increased in frequency over a period of 5 days. Findings from the clinical examination were notable for mild dehydration and a possible olive-sized mass, approximately 2 cm in diameter, that was..
December 14, 2017: New England Journal of Medicine
Ziad A Bataineh, Nathan M Novotny
OBJECTIVE: Since the loss of the protected arthrotomy knife several years ago, pediatric surgeons have struggled to find a safe, reliable, and inexpensive way to incise the pyloric serosa before spreading the muscle. The most widely accepted method of cutting the serosa is with electrocautery, although some still question its safety. We introduce a novel technique of incising the serosa with a percutaneously inserted needle without the use of electrocautery. DESCRIPTION: In this case series, we describe the experience of a single surgeon with a novel technique of incising the serosa...
December 13, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Kiarash Taghavi, Emma Powell, Bhaveshkumar Patel, Craig A McBride
Over the last hundred years, idiopathic hypertrophic pyloric stenosis has undergone an evolution in treatment, with subsequent improvements in outcome. Initially, it was treated by physicians with antispasmodics and various alternative feeding and resuscitation modalities. The evolution of surgical approaches led to a revolution in outcome, from almost certain death to complete cure. The progression of surgical and medical treatments is reviewed in this article until, ultimately, Ramstedt's pyloromyotomy is reached...
November 2017: Journal of Paediatrics and Child Health
Aakash Pandita, Deepak Sharma, Srinivas Murki, Tejo Pratap Oleti, Vallamsetty Leelakumar
No abstract text is available yet for this article.
January 1, 2017: Tropical Doctor
Y González Ruiz, A Siles Hinojosa, N Álvarez García, R Fernández Atuán, P Bragagnini Rodríguez, J Elías Pollina
OBJECTIVES: To analyze the correlation between pyloric size and evolution of patients surgically treated for infantile hypertrophic pyloric stenosis (IHPS). PATIENTS AND METHODS: We realized a retrospective study of 109 patients undergoing IHPS in 5 years. We analyzed by χ2 test if a correlation between evolution time, age and postoperative vomiting and gastroesophageal reflux disease (GERD), and pyloric muscle thickness (group A > 4.5 mm and group B ≤ 4...
July 20, 2017: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
Yousef El-Gohary, Abdelhafeez Abdelhafeez, Elizabeth Paton, Ankush Gosain, Andrew J Murphy
Despite hypertrophic pyloric stenosis (HPS) being one of the most frequently treated pediatric surgical conditions, its etiology remains incompletely understood. We review the diagnosis and treatment of this condition with an emphasis on the evolution of surgical techniques that led to laparoscopic pyloromyotomy, the most frequently performed technique for HPS today. In addition, we review key developments in the understanding of HPS etiology and treatment, including the postulated etiology of work-induced hypertrophy of the pylorus, its association with prokinetic macrolide antibiotics, and the emerging role of atropine sulfate as a medical treatment for HPS or a rescue treatment for incomplete myotomy...
January 2018: Pediatric Surgery International
Paul K H Tam, Patrick H Y Chung, Shawn D St Peter, Christopher P Gayer, Henri R Ford, Greta C H Tam, Kenneth K Y Wong, Mikko P Pakarinen, Mark Davenport
Recent developments in paediatric gastrointestinal surgery have focused on minimally invasive surgery, the accumulation of high-quality clinical evidence, and scientific research. The benefits of minimally invasive surgery for common disorders like appendicitis and hypertrophic pyloric stenosis are all supported by good clinical evidence. Although minimally invasive surgery has been extended to neonatal surgery, it is difficult to establish its role for neonatal disorders such as oesophageal atresia and biliary atresia through clinical trials because of the rarity of these disorders...
September 9, 2017: Lancet
Suihong Ma, Jianhua Liu, Youxiang Zhang, Yuwen Yang, Hai Jin, Xiaomei Ma, Hongqin Wei
Congenital Hypertrophic Pyloric Stenosis (CHPS) is a disease condition that is caused as a result of pylorus wall hypertrophy and hyperplasia. In this study, we used color Doppler flow imaging (CDFI) and Doppler artifacts technique to observe the blood flow of hypertrophic pylorus tissue and the dynamic imaging of liquid passing through the pyloric canal in CHPS infants. 65 cases of CHPS infants and 50 infants without CHPS served as control group. We found that there were statistically significant differences between the blood flow grade of muscular layer and mucosal layer between CHPS and control infants, but no significant differences were observed in the same group...
August 25, 2017: Scientific Reports
Hamdi Louati, Hayet Zitouni, Manel Belhajmansour, Mahdi Ben Dhaou, Mohamed Jalouli, Riadh Mhiri, Rim Kallel, Tahya Boudawara
No abstract text is available yet for this article.
April 2017: Journal of Neonatal Surgery
Jing Li, Wei Gao, Ji-Min Zhu, Wei Zuo, Xiang Liu
OBJECTIVE: To analyze the clinical and epidemiological features of patients with infantile hypertrophic pyloric stenosis (IHPS) so as to provide scientific evidence for diagnosis and prevention of IHPS. METHODS: We performed a retrospective study of infants with IHPS diagnosed from 2012 to 2015 at Anhui Provincial Children's Hospital. Demographic characteristics and clinical data were collected. RESULTS: Three hundred four patients (264 males and 40 females) were studied, of which 94...
July 27, 2017: Journal of Maternal-fetal & Neonatal Medicine
Giuseppe Lauriti, Valentina Cascini, Pierluigi Lelli Chiesa, Agostino Pierro, Augusto Zani
No abstract text is available yet for this article.
July 12, 2017: European Journal of Pediatric Surgery
Carlos A Cuello-Garcia
No abstract text is available yet for this article.
July 2017: Journal of Pediatrics
Nick Lansdale, Nadeem Al-Khafaji, Patrick Green, Simon E Kenny
OBJECTIVES: Determine national outcomes for pyloromyotomy; how these are affected by: (i) surgical approach (open/laparoscopic), or (ii) centre type/volume and establish potential benchmarks of quality. METHODS: Hospital Episode Statistics data were analysed for admissions 2002-2011. Data presented as median (IQR). RESULTS: 9686 infants underwent pyloromyotomy (83% male). Surgery was performed in 22 specialist (SpCen) and 39 nonspecialist centres (NonSpCen)...
May 21, 2017: Journal of Pediatric Surgery
Matthias Nissen, Grigore Cernaianu, Rene Thränhardt, Mohammad R Vahdad, Karin Barenberg, Ralf-Bodo Tröbs
BACKGROUND: This pilot study focuses on regional tissue oxygenation (rSO2 ) in patients with infantile hypertrophic pyloric stenosis in a perioperative setting. To investigate the influence of enhanced metabolic alkalosis (MA) on cerebral (c-rSO2 ) and renal (r-rSO2 ) tissue oxygenation, two-site near-infrared spectroscopy (NIRS) technology was applied. MATERIALS AND METHODS: Perioperative c-rSO2 , r-rSO2 , capillary blood gases, and electrolytes from 12 infants were retrospectively compared before and after correction of MA at admission (T1), before surgery (T2), and after surgery (T3)...
May 15, 2017: Journal of Surgical Research
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