Pyloromyotomy: Open or Lap?
Topic overview
Systematic review comparing laparoscopic versus open pyloromyotomy for infantile hypertrophic pyloric stenosis. Analysis of 7 RCTs with 720 infants found laparoscopic approach may slightly increase mucosal perforation and incomplete myotomy risks, though evidence certainty is low.
Key takeaways
- Laparoscopic pyloromyotomy may increase mucosal perforation risk compared to open approach, though absolute risk remains low.
- Incomplete pyloromyotomy may occur more frequently with laparoscopic technique, but evidence is limited and imprecise.
- No clear difference in hospital stay, time to full feeds, or operating time between laparoscopic and open pyloromyotomy.
- Evidence quality is low to very low for most outcomes due to study design limitations and small sample sizes.
- Surgeon experience and training effects on outcomes remain unclear and require further investigation.
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