Post-laparoscopic pyloromyotomy vomiting: analysis of predictors other than incomplete pyloromyotomy
Abstract
Purpose Post-pyloromyotomy vomiting (PPV) is common problem. Some cases continue vomiting despite of adequate
pyloromyotomy. Several pre- and postoperative factors may have a role. The aim of this study is to detect infants at risk of
prolonged PPMV.
Methods Fifty-three infants with infantile hypertrophic pyloric stenosis were operated at single tertiary center. Laparoscopic
pyloromyotomy was performed in all cases. According to toleration of oral intake, patients were categorized in two groups,
A and B. Group A included cases who didn’t vomit or vomited and stopped vomiting during the first 8 h postoperative, while
group B included cases who continued vomiting for more than 8 h postoperative and got improved by time.
Results Mean age was 30.24 and 38.23 days in group A and B, respectively. Mean body weight was 2.7 and 2.4 kg. Mean
duration of symptoms was 12.3 and 18.4 days. Mean pyloric canal length was 18.6 and 20.2 mm. Mean muscle thickness
was 4.5 and 6.9 mm.
Conclusion There is prolonged period of PPV with increase of pyloric canal length, pyloric thickness, and duration of preoperative
vomiting. PPV decreases with minmum body weight loss of infant at the time of operation.