Double Incomplete Pyloromyotomy (A. Ezzat Technique): A New Technique for Infantile Hypertrophic Pyloric Stenosis: Preliminary Study

Ahmed Ezzat Rozeik^1*, Radi Elsherbini², Hamdi Almaramhy³

¹Pediatric Surgery Unit, Zagazig University, Al Sharqia Governorate, Egypt.
²Pediatric Surgery Unit, Mansoura University, Mansoura, Egypt.
³Faculty of Medicine, Taibah University, Medina, KSA.

DOI: 10.4236/ojped.2014.44034                

Abstract

Background-Purpose: The study aimed to see the outcome of Double Incomplete Pyloromyotomy as new technique for surgical management of infantile hypertrophic pyloric stenosis (IHPS). Methods: This study was conducted in pediatric surgery unite, Zagazig University Hospital, Egypt. Fifteen patients were included in this study (11 male and 4 female) with IHPS from January 2012 to January 2013. Under general anesthesia, two longitudinal separated incisions at different planes as pyloromyotomy. Results: Postoperative vomiting and weight gain were recorded. Follow up period was 3 months. Vomiting improved within first 48 hours then stopped after that. Weight gain significantly increased after theoperation when compared preoperatively. Conclusion: Double Incomplete Pyloromyotomy is a new, safe and effective procedure for treatment of infantile hypertrophic pyloric stenosis.

Keywords

Hypertrophic Pyloric Stenosis, Double Incomplete Pyloromyotomy

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Panteli, C. (2009) New Insights into Pathogenesis of Infantile Pyloric Stenosis. Pediatric Surgery International, 25, 1043-1052. http://dx.doi.org/10.1007/s00383-009-2484-x
[2]	Gotly, L., Bland, A., Kimble, R., et al. (2009) Pyloric Stenosis: A Retrospective Study of an Australian Population. Emergency Medicine Australasia, 21, 407-413.
[3]	Chan, S.M., Chan, E.R., Chu, W.C., Cheung, S.T., Tam, Y.H. and Lee, K.H. (2011) Hypertrophic Pyloric Stenosis in a New Born: A Diagnostic Dilemma. Hong Kong Medical Journal, 17, 245-247.
[4]	Mahalik, S., Prasad, A., Sinha, A. and Kulshrestha, R. (2010) Delayed Presentation of Hypertrophic Pyloric Stenosis: A Rare Case. Journal of Pediatric Surgery, 45, 9-11. http://dx.doi.org/10.1016/j.jpedsurg.2009.11.012
[5]	Huang, Y.L., Lee, H.C., Yeung, C.Y., Chen, W.T., Jiang, C.B., Shew, J.C. and Wang, N.L. (2009) Sonogram before and after Pyloromyotomy: The Pyloric Ratio in Infantile Hypertrophic Stenosis. Pediatrics & Neonatology, 50, 117-120. http://dx.doi.org/10.1016/S1875-9572(09)60046-2
[6]	Muramori, K., Nagasaki, Y. and Kawanami, T. (2002) Ultrasonographic Serial Measurement of Morphologic Resolution of the Pylorus after Ramstedt’s Pyloromyotomy for Infantile Hypertrophic Pyloric Stenosis. Journal of Ultrasound in Medicine, 26, 1681-1687.
[7]	Aspelund, G. and Langer, J.C. (2007) Current Management of Hypertrophic Pyloric Stenosis. Seminars in Pediatric Surgery, 16, 27-33. http://dx.doi.org/10.1053/j.sempedsurg.2006.10.004
[8]	Karen, W., Robert, H., Andrew, J.A., Caroline, K. and Nadia, B. (2010) Early Development Outcome of Infants with Infantile Hypertrophic Pyloric Stenosis. Journal of Pediatric Surgery, 45, 2369-2372. http://dx.doi.org/10.1053/j.sempedsurg.2006.10.004
[9]	Esmaeel, T., John, B., Sherif, E., Sebastien, D., Pramod, P., Helen, F. and Jean, M. (2007) Evaluation of Surgical Approaches to Pyloromyotomy: A Single-Center Experience. Journal of Pediatric Surgery, 42, 865-868. http://dx.doi.org/10.1053/j.sempedsurg.2006.10.004
[10]	Yagmurlu, A., Chalmer, J., Yoyngson, G., et al. (2004) Comparison of the Incidence of Complications in Open and Laparoscopic Pyloromyotomy: A Concurrent Single Institution Series. Journal of Pediatric Surgery, 39, 292-296. http://dx.doi.org/10.1016/j.jpedsurg.2003.11.047
[11]	Alalayet, Y.F., Miserez, M., Mansoor, K. and Khan, A.M. (2009) Double-Y Pyloromyotomy: A New Technique for Surgical Management of Infantile Hypertrophic Pyloric Stenosis. European Journal of Pediatrics, 19, 17-20. http://dx.doi.org/10.1055/s-2008-1039025
[12]	Tam, P.K., Saing, H., Koo, J., et al. (1985) Pyloric Function Five to Eleven Years after Ramstedt’s Pyloromyotomy. Journal of Pediatric Surgery, 20, 236-239.
[13]	Sun, W.M., Doran, S.M., Jones, K.L., Davidson, G., Dent, J. and Horowitz, M. (2000) Long-Term Effect of Pyloromyotomy on Motility and Gastric Emptying. The American Journal of Gastroenterology, 95, 92-100. http://dx.doi.org/10.1111/j.1572-0241.2000.01705.x
[14]	Lasheen, A.E., Morsy, M.M. and Fiad, A.A. (2011) Segmental Internal Sphincterotomy: A New Technique for Treatment of Chronic Anal Fissure. Journal of Gastrointestinal Surgery, 15, 2271-2274. http://dx.doi.org/10.1007/s11605-011-1689-1