Evaluation of Pyloric Stenosis Management, Laparoscopic versus Open Pyloromyotomy

Abstract

Background: Hypertrophic pyloric stenosis (HPS) is associated with gastric outlet obstruction that occurs as a result of pylorus muscular layers hypertrophy. HPS is considered as the most common cause of vomiting in infancy that requires surgical intervention. Despite advances in neonatal and surgical care, still there is a debate between the pediatric surgeons about the approach that can provide better outcomes for the patients. Objective: In our paper, we aimed to review the recent randomized clinical trials and reviews that compared between laparoscopic and open pyloromyotomy to assess their outcomes, merits and pitfall of each. Methods: PubMed database was used for articles selection, and the following keys used in the mesh (Hypertrophic Pyloric Stenosis /management[Mesh] OR Hypertrophic Pyloric Stenosis /outcomes[Mesh]) AND (Mortality/Morbidity[Mesh]). A total of 12 studies were enrolled into our review according to our inclusion and exclusion criteria. Conclusion: We found that overall Laparoscopic pyloromyotomy procedures were as safe and effective as Open pyloromyotomy procedures for infants with hypertrophic pyloric stenosis. However, there was a trend in the LP group towards shorter time, especially with regard to the full time to feeds, length of stay after surgery, operating time. We think that our findings justify the continued use of laparoscopic pyloromyotomy for the management of infantile hypertrophic pyloric stenosis, and recommend its use in centers with appropriate laparoscopic experience.