INFANTILE HYPERTROPHIC PYLORIC STENOSIS: POSTOPERATIVE MANAGEMENT WITHOUT PROLONGED FASTING OR NASOGASTRIC TUBE
Basrah Journal of Surgery,
2015, Volume 21, Issue 2, Pages 50-54
Infantile hypertrophic pyloric stenosis is the most common condition requiring surgery in the first few months of life and also the most common surgical cause of vomiting in infancy.
All pediatric surgeons agreed that Ramstad's operation (pyloric sero-myotomy) is the standard choice of surgical correction, however, the perioperative management is controversial, specially that is related to and recommended for the time of resumption of feeding postoperatively.
The present work is prospective comparative study reviews 55 infants diagnosed as having hypertrophic pyloric stenosis over a 2 years period and subjected to pyloromyotomy. Postoperatively, 22 (40%) patients managed without the use of nasogastric tube and early introduction of oral feeding. The remaining 33 (60%) patients were managed classically with nasogastric tube decompression and delayed introduction of oral feeding until the next morning. This study was designed to compare between the two groups and to verify if there will be any significant effect on the postoperative course.
Statistical analysis of the postoperative incidence of vomiting, postoperative complications, and hospital stay showed that there were no significant differences between the two groups of patients. Therefore, non-use of postoperative nasogastric tube and early feeding are safe postoperative approach in the management of infantile hypertrophic stenosis and may be the preferred method of postoperative management.
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