Safety and benefit of ad libitum feeding following laparoscopic pyloromyotomy: retrospective comparative trial
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In brief
In brief
Retrospective study of 336 infants comparing ad libitum versus structured feeding after laparoscopic pyloromyotomy found ad libitum feeding reduced time to goal feeding (10.7 vs 18.7 hours) and discharge (21.6 vs 23.1 hours) with similar readmission rates despite higher postoperative emesis.
Written by the GCMD Library team from the article.
Abstract
Purpose
In this study, we evaluated the impacts of ad libitum feedings on outcomes following laparoscopic pyloromyotomy in patients with infantile hypertrophic pyloric stenosis.
Methods
Pediatric patients with infantile hypertrophic pyloric stenosis who underwent laparoscopic pyloromyotomy were included. Patients were stratified into ad libitum and structured feeding groups. Primary outcomes were times from surgery completion to goal feeding and discharge.
Results
A total of 336 patients were included in the study with 63 patients (18.8%) in the ad libitum feeding group. The ad libitum feeding group experienced significantly shorter times from surgery completion to both goal feedings (10.7 h vs 18.7 h; p < 0.001) and hospital discharge (21.6 h vs 23.1 h; p = 0.008) compared to the structured protocol group. Postoperative emesis (47.% vs 30.8%; p = 0.011) was higher in the ab libitum cohort, but the rates of return to an emergency department and/or readmission (4.8% vs 2.2%; p = 0.26) were similar.
Conclusion
Ad libitum feeding after pyloromyotomy decreases time to reach goal feeding and hospital discharge. While it may contribute to a higher incidence of emesis, it does not appear to significantly increase hospital readmission. Ad libitum feeding appears to be a safe and beneficial alternative to structured feeding protocols following pyloromyotomy.
Level of evidence
III.