Meta-analysis of Laparoscopic versus open pyloromyotomy

Nigel J. Hall, Jill Van Der Zee, Hock L. Tan, Agostino Pierro

Research output: Contribution to journalArticle

98 Citations (Scopus)

Abstract

Objective: To perform a meta-analysis of studies comparing open pyloromyotomy (OP) and laparoscopic pyloromyotomy (LP) in the treatment of infantile hypertrophic pyloric stenosis. Background: LP has become increasingly popular for the management of pyloric stenosis. Despite a decade of experience, the real benefit of LP over the open procedure remains unclear. Methods: Using a defined search strategy, studies directly comparing OP with LP were identified (n = 8). Data for infants treated by both approaches were extracted and used in our meta-analysis. OP and LP were compared in terms of complications, efficacy, operating time, and recovery time. Weighted mean difference (WMD) between continuous variables and 95% confidence intervals (95% CI) were calculated. For dichotomous data, relative risk (RR) and 95% CI were determined. Results: Only 3 studies were prospective, and just 1 study was a prospective randomized controlled trial. Mucosal perforations and incomplete pyloromyotomy were both more common with LP. Compared with OP, LP is associated with higher complication rate (RR 0.81 [0.5, 1.29], P = 0.4), similar operating time (WMD 1.52 minutes [-0.26, 3.29], P = 0.09), shorter time to full feeds (WMD 8.66 hours [7.25, 10.07], P < 0.00001), and shorter postoperative length of stay (WMD 7.03 hours [3.74, 10.32], P = 0.00003). Conclusions: OP is associated with fewer complications and higher efficacy. Recovery time appears significantly shorter following LP. A prospective randomized controlled trial is warranted to fully investigate these and other outcome measures.

Original languageEnglish
Pages (from-to)774-778
Number of pages5
JournalAnnals of Surgery
Volume240
Issue number5
DOIs
Publication statusPublished - Nov 2004
Externally publishedYes

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Meta-Analysis
Randomized Controlled Trials
Pyloric Stenosis
Confidence Intervals
Length of Stay
Outcome Assessment (Health Care)
Prospective Studies
Therapeutics

ASJC Scopus subject areas

  • Surgery

Cite this

Hall, N. J., Van Der Zee, J., Tan, H. L., & Pierro, A. (2004). Meta-analysis of Laparoscopic versus open pyloromyotomy. Annals of Surgery, 240(5), 774-778. https://doi.org/10.1097/01.sla.0000143250.48265.d6

Meta-analysis of Laparoscopic versus open pyloromyotomy. / Hall, Nigel J.; Van Der Zee, Jill; Tan, Hock L.; Pierro, Agostino.

In: Annals of Surgery, Vol. 240, No. 5, 11.2004, p. 774-778.

Research output: Contribution to journalArticle

Hall, NJ, Van Der Zee, J, Tan, HL & Pierro, A 2004, 'Meta-analysis of Laparoscopic versus open pyloromyotomy', Annals of Surgery, vol. 240, no. 5, pp. 774-778. https://doi.org/10.1097/01.sla.0000143250.48265.d6
Hall, Nigel J. ; Van Der Zee, Jill ; Tan, Hock L. ; Pierro, Agostino. / Meta-analysis of Laparoscopic versus open pyloromyotomy. In: Annals of Surgery. 2004 ; Vol. 240, No. 5. pp. 774-778.
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