Pyloromyotomy Essay

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PATIENTS AND METHODS This an interventional comparative randomized prospective study conducted on 40 patients with infantile hypertrophic pyloric stenosis indicated for pyloromyotomy. 20 patients underwent laparoscopic pyloromyotomy (LP) and the other 20 patients underwent umbilical pyloromyotomy (UP). Patients characteristics including,age,gender ,gestational age (full term, preterm), associated comorbidities were documented. Intraoperative details e.g. operative time and complications and postoperative outcomes e.g.; time to full feedings, incidence of postoperative vomiting, hospital stay and wound dehiscence were recorded. The study was approved by the Research Ethics Committee of the pediatric surgery department, Faculty of Medicine, Cairo University. Informed written consent was obtained from the parents of all patients. Every patients guardian was asked to give a score of his / her satisfaction regarding the cosmetic appearance of the scar and an overall grading regarding how he / she feels about this kind of technique and weather he /she feels his /her child had become normal or not after the operation. Scoring was…show more content…
The epigastric skin was undermined and the peritoneal cavity opened through the linea alba. The stomach was grasped proximal to the pylorus with non -crushing clamp, and then the pylorus can be gently delivered through the wound. A seromuscular incision was made with a scalpel at the longitudinal axis of the pylorus, commencing 1 -2 mm proximal to the prepyloric vein along the gastric antrum at least 0.5 -1.0 cm from the antropyloric junction. Then pyloric muscle was spread widely till the intact mucosa bulges as evidence of a satisfactory myotomy. The stomach was inflated through the nasogastric tube to exclude mucosal perforation. Then the pylorus was returned back into the abdomen and rectus sheath and skin were

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