Eur J Pediatr Surg 2011; 21(2): 77-81
DOI: 10.1055/s-0030-1261926
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Open versus Laparoscopic Pyloromyotomy for Pyloric Stenosis: A Meta-analysis of Randomized Controlled Trials

W.-Q. Jia1 , J.-H. Tian1 , K.-H. Yang1 , 2 , B. Ma1 , Y.-L. Liu1 , P. Zhang1 , 2 , R.-J. Li1 , 3 , R.-H. Jia4
  • 1Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, China
  • 2The first Clinical Medical College, Lanzhou University, China
  • 3Institute of Urology, The Second Hospital of Lanzhou University, China
  • 4Institute of Imaging, Gansu Province Hospital of Traditional Chinese Medicine, China
Further Information

Publication History

received December 05, 2009

accepted after revision April 05, 2010

Publication Date:
18 October 2010 (online)

Abstract

Objective: Aim of the study was to compare the outcomes after laparoscopic pyloromyotomy (LP) with those of open pyloromyotomy (OP) for infantile pyloric stenosis.

Method: We conducted searches until February 2009 in multiple databases and identified randomized controlled trials comparing LP with OP for pyloric stenosis. Results were expressed using the odds ratio (OR) for categorical variables and standard weighted mean differences (SMD) for continuous outcomes. Study quality was assessed using the Cochrane Handbook 5.0.1 guidelines and statistical analysis was performed using RevMan 5.0.8 software.

Results: 3 studies totaling 492 infants were included. The results showed no significant differences in complications between the groups with regard to wound infection (OR: 1.77, 95% CI 0.58–5.35), mucosal perforations (OR: 0.96, 95% CI: 0.22–4.26), incisional hernia or granuloma (OR: 1.39, 95% CI: 0.41–4.73), incomplete pyloromyotomy (OR: 0.13, 95% CI: 0.02–1.07), substantial vomiting (OR: 0.67, 95% CI: 0.30–1.52) and total complications (OR: 0.91, 95% CI: 0.54–1.53). Although the combined result of 2 studies also indicated an insignificant discrepancy in time-related outcomes for full time to feeds, length of stay after surgery and operating time (SMD: 0.78, 95% CI: −0.50–2.06; SMD: 1.27, 95% CI: −1.56–4.10; SMD: −0.46, 95% CI: −1.11–0.20, respectively), another study indicated shorter times for LP procedures (p=0.002, 0.027, and 0.008, respectively).

Conclusions: Only a few trials were available for analysis. Heterogeneity was seen between studies, but the available trials were of high quality. The present study shows that both OP and LP are equally safe and effective procedures for the management of pyloric stenosis in children. However, there was a trend in LP toward shorter time time-related outcomes.

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Correspondence

KeHu Yang

Evidence Based Medicine Center

School of Basic Medical Sciences

Lanzhou University

Dong Gang Road NO 199

+86730000 Lanzhou

China

Phone: +86 891 5076

Fax: +86 891 5076

Email: kehuyangebm2006@126.com