LAPAROSCOPIC EXPLORATION FOR INFANTILE HYPERTROPHIC PYLORIC STENOSIS: AN EXPERIENCE AT TERTIARY CARE HOSPITAL

Dr. Sajjad Ali Senior Registrar, Muhammad Imran, Sajad Ali, Fayaz Rahman, Khawar Saeed, Mahjabina S. Ghayur
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Abstract

Objectives: This study aims to share our experience of laparoscopic exploration for infantile hypertrophic pyloric stenosis. Material and methods: This retrospective study was conducted in the Department of Pediatric Surgery, Khyber Teaching Hospital, Peshawar from June 2017 to July 2020. This study includes all patients whose diagnosis of infantile hypertrophic pyloric stenosis (IHPS) was confirmed through ultrasound parameters and laparoscopic pyloromyotomy was performed. Data was retrieved from the laparoscopic surgery record. Retrieved data was tabulated and fed in SPSS 25 for analysis. Results: This study included 42 patients with a mean age of 50.28 ±18.5days and a mean weight of 3.35±0.76 kg. Male patients were 57 % while females were 43 %. The mean time to resuscitate the patient pre-operatively was 34.6±15.4 hours while the mean postoperative hospital stay was 45±12.47 hours. The mean operative time was 31.6±10.4 min. Operative time decreased with time depicting improvement in our learning curve (p=0.004). The method of working instrument placement had no impact on operative time (p=0.337). Meantime to full oral feed was 9.7±5.1 hours. We did not encounter mucosal perforation or incomplete myotomy. No surgery was converted to open. Conclusion: Laparoscopic pyloromyotomy is a safe and effective method of treatment for infantile hypertrophic pyloric stenosis. Keywords:  laparoscopic pyloromyotomy, pyloric stenosis, IHPS
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腹腔镜探查婴儿肥厚性幽门狭窄:三级医院的经验
研究目的本研究旨在分享我们对婴儿肥厚性幽门狭窄进行腹腔镜探查的经验:这项回顾性研究于 2017 年 6 月至 2020 年 7 月在白沙瓦开伯尔教学医院小儿外科进行。本研究包括所有通过超声参数确诊为婴儿肥厚性幽门狭窄(IHPS)并实施腹腔镜幽门切开术的患者。数据取自腹腔镜手术记录。检索到的数据制成表格,并输入 SPSS 25 进行分析:本研究共纳入 42 名患者,平均年龄(50.28±18.5 天),平均体重(3.35±0.76 公斤)。男性患者占 57%,女性患者占 43%。术前平均抢救时间为(34.6±15.4)小时,术后平均住院时间为(45±12.47)小时。平均手术时间为 31.6±10.4 分钟。手术时间随着时间的推移而缩短,说明我们的学习曲线有所改善(P=0.004)。放置工作器械的方法对手术时间没有影响(P=0.337)。完全进食所需时间为 9.7±5.1 小时。我们没有遇到粘膜穿孔或肌切开不完全的情况。没有手术转为开放手术:关键词:腹腔镜幽门切开术 幽门狭窄 IHPS
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