Pyloromyotomy in Hypertrophic Pyloric Stenosis: A Comparative Study Between Supraumbilical Curved Skin Incision and Standard (Right Upper Quadrant) Skin Incision: Study in a Resource Limited Setting

Abstract

Mehran Peyvasteh,1 Shahnam Askarpour,1 Mahmood Khoshkhabar,1 Hazhir Javaherizadeh2 1Department of Pediatric Surgery, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; 2Alimentary Tract Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IranCorrespondence: Shahnam AskarpourDepartment of Pediatric Surgery, Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran, Email [email protected]: The main therapeutic option for hypertrophic pyloric stenosis (HPS) is pyloromyotomy surgical technique which can be performed via different methods, including right upper quadrant (RUQ) transverse incision and supraumbilical curved skin incision; thus, the aim of this study was to evaluate and compare clinical efficacy of supraumbilical curved skin incision and standard (RUQ) skin incision.Materials and Methods: In this retrospective case-control study, 35 patients with HPS were initially evaluated. After evaluating hospital records, 31 patients with completed hospital records were included: 9 from case group and 22 from control group. Demographic information, surgery parameters and postoperative complications were extracted from the hospital records or calling parents.Results: Results showed that the surgery parameters such as surgery duration (P=0.211), postoperative fasting duration (P=0.831), and hospitalization duration (P=0.521) in both groups were similar. Moreover, surgery complications such as duodenal or gastric perforation and surgical site infection did not differ between the groups (P> 0.05). While we found that Vancouver Scar Scale was significantly lower in supraumbilical curved skin incision as compared to control group (1.8 ± 0.5 vs 5.1 ± 0.7, P< 0.001, respectively).Conclusion: The results of this study showed the beneficial effects of supraumbilical curved skin incision technique on surgery scar outcomes and gives best cosmetic results with minimal complications, which could be replaced to RUQ operative technique and significantly lead to better control of surgery scar.Keywords: hypertrophic pyloric stenosis, supraumbilical curved skin incision, right upper quadrant transverse incision

Keywords

• hypertrophic pyloric stenosis
• supraumbilical curved skin incision
• right upper quadrant transverse incision