scholarly journals The Safety and Effectiveness of Laparoscopic Pyloromyotomy Using 3-mm Electrocautery Hook versus Open Surgery for Treatment of Hypertrophic Pyloric Stenosis in Infants

Children ◽  
2021 ◽  
Vol 8 (8) ◽  
pp. 701
Author(s):  
Zenon Pogorelić ◽  
Ana Zelić ◽  
Miro Jukić ◽  
Carlos Martin Llorente Muñoz
Keyword(s):  
Hospital Stay ◽  
Wound Infection ◽  
Pyloric Stenosis ◽  
Hypertrophic Pyloric Stenosis ◽  
Oral Intake ◽  
Laparoscopic Group ◽  
Open Group ◽  
Open Approach ◽  
Duration Of Surgery ◽  
Laparoscopic Pyloromyotomy

Background: The standard of treatment for infants with hypertrophic pyloric stenosis is still pyloromyotomy. Recently, in most of the pediatric surgery centers laparoscopic pyloromyotomy has become popular. The aim of the present study is to compare the outcomes of treatment in infants with hypertrophic pyloric stenosis between traditional open approach and laparoscopic pyloromyotomy using 3-mm electrocautery hook. Methods: A total of 125 infants, 104 (83.2%) males, with median age 33 (interquartile range, IQR 24, 40) days, who underwent pyloromyotomy because of hypertrophic pyloric stenosis, between 2005 and 2021, were included in the retrospective study. Of that number 61 (48.8%) infants were allocated to the open group and 64 (51.2%) to the laparoscopic group. The groups were compared in regards to time to oral intake, duration of surgery, the type and rate of complications, rate of reoperations, frequency of vomiting after surgery, and the length of hospital stay. Results: No differences were found with regards to baseline characteristics between two investigated groups. Laparoscopic approach was associated with significantly better outcomes compared to open approach: shorter duration of surgery (35 min (IQR 30, 45) vs. 45 min (40, 57.5); p = 0.00008), shorter time to oral intake (6 h (IQR 4, 8) vs. 22 h (13.5, 24); p < 0.00001), lower frequency of postoperative vomiting (n = 10 (15.6%) vs. n = 19 (31.1%)), and shorter length of postoperative hospital stay (3 days (IQR 2, 3) vs. 6 days (4.5, 8); p < 0.00001). In regards to complications and reoperation rates, both were lower in the laparoscopic pyloromyotomy group but the differences were not statistically significant (p = 0.157 and p = 0.113, respectively). The most common complication in both groups was mucosal perforation (open group, n = 3 (4.9%); laparoscopic group, n = 2 (3.1%)) followed by wound infection in open group, n = 3 (4.9%). No cases of wound infection were recorded in the laparoscopic group. Conclusion: Open and laparoscopic pyloromyotomy are equally safe and effective in treatment of hypertrophic pyloric stenosis. Laparoscopic technique is associated with faster recovery, shorter duration of surgery and shorter duration of hospital stay.

scholarly journals LAPAROSCOPIC COLORECTAL SURGERY;

2018 ◽  
Vol 21 (04) ◽  
pp. 583-586
Author(s):  
Zulfiqar Hanif ◽  
Muhammad Attique ◽  
Haitham Qandeel ◽  
Abdul Latif Khan
Keyword(s):  
Colorectal Surgery ◽  
Hospital Stay ◽  
Laparoscopic Colorectal Surgery ◽  
Laparoscopic Group ◽  
Open Group ◽  
Port Site Recurrence ◽  
Long Term Outcome ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
The Mean

Objective: The aim of this study was to assess the outcome of laparoscopiccolorectal procedures performed in a district general hospital within 5 years period and tocompare it with patients who had an open procedure during the same period. Patients andMethods: Data were collected retrospectively from patient’s case notes retrieved from hospitalmedical records. One hundred consecutive cases of laparoscopic colonic resection includingboth benign and malignant diseases between 2005 and 2010 were analysed for perioperativeand long term outcome and were compared with consecutive one hundred cases of opencolectomies. Results: Overall conversion rate was 6% for laparoscopic group. The mean majorcomplication rates in laparoscopic group were 5% (3% in open group) and minor complicationsoccurred in 18% (28% in open group). There was no mortality in either group. The overallmorbidity rate was 23% in laparoscopic group as compared to 31% in open colectomy group. In64 cases, curative laparoscopic resections were performed for colorectal malignancy while 72patients had resections for cancer in open group. The mean lymph node harvest in laparoscopicgroup was 13.2 nodes as compared to 12.4 in open group; no port-site recurrence wasdocumented at a mean follow-up of 26 months. Average duration of surgery was 180 minutes ascompared to 140 minutes in open group. Mean postoperative hospital stay was reduced from 13days to 7 days. (Open Vs. Lap). There was no statistically significant difference in majorcomplication rates and mortality. Conclusions: Laparoscopic colorectal surgery is safe andfeasible in elective colorectal cases and reduces the hospital stay without any added morbidity.

scholarly journals Comparative study on open appendicectomy versus laparoscopic appendicectomy in a tertiary care centre

2018 ◽  
Vol 5 (4) ◽  
pp. 1240
Author(s):  
Naraintran S. ◽  
Sandeep Kumar David S. ◽  
Raveendran K. ◽  
Eashwara Pilla B. K.
Keyword(s):  
Comparative Study ◽  
Hospital Stay ◽  
Wound Infection ◽  
Laparoscopic Appendicectomy ◽  
Open Group ◽  
Open Appendicectomy ◽  
Group 4 ◽  
Duration Of Surgery ◽  
Operative Complications ◽  
Post Operative Complications

Background: Appendicectomy is one of the most common procedure in general surgery, accounts for approximately 1% of all surgical operation. Laparoscopic appendicectomy are likely to have less postoperative pain, early discharge, decreased wound infection, better cosmesis and also early return to routine work. Laparoscopic procedure for appendicectomy is compared with open surgical technique with respect to duration of surgery, post operative pain, duration of analgesic, post operative complications, post operative length of hospital stay and return to routine work.Methods: This is a prospective and comparative study from September 2013 to August 2014 involved 100 cases, 50 open and 50 lap appendicectomy, which were randomly selected and were operated in department of surgery, Dr S. M. C. S. I. Medical College, Karakonam.Results: In present study pain score was 2.7±0.9 for open group as compared to 1.3±0.5 in lap group (P<0.05) because of longer incision stretch of muscles and wound infection. Post operative complications like vomiting was lower in laparoscopic group with 8% as compared with 36% in open group (P<0.05) and ileus was lower in lap group with 17.3±7.1 and for open group 30.8±8.9 with P<0.05 which were significant. There is significant reduction in incidence of post operative wound infection in lap group 4% as compared to open group 26% (P<0.05). Duration of post operative hospital stay was significantly low for lap group 2.8±0.9 as compared to open group 4±2.9. The return to normal activity was low for lap group 8±3.15 days as compared to open group 13.7±3.15 days. Duration of surgery for open appendicectomy was 48.2±12.4 and for lap appendicectomy was 68.5±20.3.Conclusions: Laparoscopic appendicectomy is better than open appendectomy in selected patients with acute or recurrent appendicitis.

scholarly journals Short-term Outcomes of Elective 2-Stage Restorative Proctocolectomy for Ulcerative Colitis in Korea: Does Laparoscopy Have Benefits?

2020 ◽  
Vol 36 (1) ◽  
pp. 41-47 ◽  
Author(s):  
Jun Woo Bong ◽  
Yong Sik Yoon ◽  
Jong Lyul Lee ◽  
Chan Wook Kim ◽  
In Ja Park ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Postoperative Complications ◽  
Restorative Proctocolectomy ◽  
Complication Rate ◽  
Laparoscopic Approach ◽  
Laparoscopic Group ◽  
Bowel Function ◽  
Open Group ◽  
Open Approach ◽  
Short Term

Purpose: This study aimed to compare the short-term outcomes of the open and laparoscopic approaches to 2-stage restorative proctocolectomy (RPC) for Korean patients with ulcerative colitis (UC).Methods: We retrospectively analyzed the medical records of 73 patients with UC who underwent elective RPC between 2009 and 2016. Patient characteristics, operative details, and postoperative complications within 30 days were compared between the open and laparoscopic groups.Results: There were 26 cases (36%) in the laparoscopic group, which had a lower mean body mass index (P = 0.025), faster mean time to recovery of bowel function (P = 0.004), less intraoperative blood loss (P = 0.004), and less pain on the first and seventh postoperative days (P = 0.029 and P = 0.027, respectively) compared to open group. There were no deaths, and the overall complication rate was 43.8%. There was no between-group difference in the overall complication rate; however, postoperative ileus was more frequent in the open group (27.7% vs. 7.7%, P = 0.043). Current smoking (odds ratio [OR], 44.4; P = 0.003) and open surgery (OR, 5.4; P = 0.014) were the independent risk factors for postoperative complications after RPC.Conclusion: Laparoscopic RPC was associated with acceptable morbidity and faster recovery than the open approach. The laparoscopic approach is a feasible and safe option for surgical treatment for UC in selective cases.

Laparoscopic pyloromyotomy for hypertrophic pyloric stenosis: Impact of experience on the results in 182 cases

2004 ◽  
Vol 18 (6) ◽  
pp. 907-909 ◽  
Author(s):  
J. D. W. van der Bilt ◽  
W. L. M. Kramer ◽  
D. C. van der Zee ◽  
N. M. A. Bax
Keyword(s):  
Pyloric Stenosis ◽  
Hypertrophic Pyloric Stenosis ◽  
Laparoscopic Pyloromyotomy

Laparoscopic Pyloromyotomy for Infantile Hypertrophic Pyloric Stenosis

2004 ◽  
Vol 8 (1) ◽  
pp. 13-17 ◽  
Author(s):  
Mari Arai ◽  
Tadashi Iwanaka ◽  
Hiroshi Kawashima ◽  
Sumi Kudou ◽  
Jun Fujishiro ◽  
...  
Keyword(s):  
Pyloric Stenosis ◽  
Hypertrophic Pyloric Stenosis ◽  
Infantile Hypertrophic Pyloric Stenosis ◽  
Laparoscopic Pyloromyotomy

scholarly journals Study of laparoscopic appendectomy: advantages, disadvantages and reasons for conversion of laparoscopic to open appendectomy

2017 ◽  
Vol 4 (3) ◽  
pp. 993
Author(s):  
Sujan Narayan Agrawal ◽  
Sunita Meshram ◽  
Kamlesh Dhruv
Keyword(s):  
Hospital Stay ◽  
Wound Infection ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Laparoscopic Approach ◽  
Normal Activity ◽  
Organ Injury ◽  
Cross Sectional ◽  
Duration Of Hospital Stay ◽  
Duration Of Surgery

Background:Good outcome has been reported with the laparoscopic approach in uncomplicated appendicitis, but a higher incidence of postoperative intraabdominal abscesses has been reported after laparoscopic appendectomy in complicated appendicitis. Objective was to study the efficacy of laparoscopic appendectomy.Methods: A Hospital based cross sectional study was carried out among of 302 patients. The study duration was from June 2004 to December 2006. Institutional Ethics Committee permission was obtained. Informed individual consent was taken. Out of 302 subjects, 236 underwent open appendectomy and 66 underwent laparoscopic appendectomy.Results:It was observed that in both the groups majority patients had retrocecal position of the appendix. The amount of blood loss, adjacent organ injury and duration of surgery were similar in both the groups. The difference in the incidence of wound infection in both groups was not found to be statistically significant. But the antibiotic use was significantly less in the LA group compared to OA group. It was found that time to resumptions of oral fees, duration of hospital stay and time to return to normal duties were significantly lesser in LA group compared to OA group. (p < 0.001). As per the cosmetic end result, majorities were satisfied in LA group and rated the surgery as excellent as compared to patients in OA group.Conclusions:Laparoscopic appendectomy was better than open appendectomy with respect to wound infection, tackling co-existing pathology, duration of hospital stay, earlier return to normal activity, excellent cosmetic end result, lesser use of antibiotics and earlier resumption of oral feeds.

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