Laparoscopic vs Open Pyloromyotomy for Treatment of Infantile Hypertrophic Pyloric Stenosis

Background: Infantile Hypertrophic Pyloric Stenosis (IHPS) frequency is 1-2:1000 live births in the United States. It is presented in neonates aged 2-8 weeks. Male to female ratio is 4:1. Aim: To evaluate laparoscopic pyloromyotomy regarding surgical outcomes and incidence of complications versus open pyloromyotomy. Patients and methods: This randomized controlled study was conducted on thirty children less than three months who were diagnosed with IHPS and divided into two groups: fifteen cases in Laparoscopic group and fifteen cases in open group at pediatric surgery department, faculty of medicine, Al-Azhar university for the duration of 1 year. Results: According to outcome of treatment, there were big differences between the two groups regarding surgical time (about 12 minutes at laparoscopic group and about 21 minutes at open group), postoperative feeding (about 6 hours at laparoscopic group and about 24 hours at open group), hospital stays (about 2 days at laparoscopic group and about 5 days at open group), and postoperative vomiting (6/15 cases at laparoscopic group and 12/15 cases at open group). According to complications, there were some differences between the two groups regarding mucosal perforation (one case of mucosal perforation at the open group and zero cases at the laparoscopic group), and ugly scar (two cases at the open group and zero cases at the laparoscopic group). Conclusion: Both methods are safe and efficient in the management of IHPS. The laparoscopic method is related to a shorter surgical time, early postoperative feeding, shorter hospital stays and better cosmesis.