1.Hypertrophic Pyloric Stenosis: 10 Years' Experience with Standard Open and Laparoscopic Approach
Nicola ZAMPIERI ; Valentina CORATO ; Gabriella SCIRÈ ; Francesco Saverio CAMOGLIO
Pediatric Gastroenterology, Hepatology & Nutrition 2021;24(3):265-272
Purpose:
Hypertrophic pyloric stenosis (HPS) is the most common cause of gastric obstruction in newborns. Extra-mucosal pyloromyotomy can be performed through a small laparotomy or laparoscopy. The aim of this study was to compare the two surgical techniques.We also analyzed the incidence of HPS in infants in the last 10 years in relation to the demographic trend of our province.
Methods:
We analyzed all the cases of HPS treated at our Unit between January 2010 and December 2019. The data were obtained from operating systems. Data about the demographic trends, in particular, the number of births and the population residing in the province of Verona from 2010 to 2019, were also retrieved.
Results:
During the study period, 60 patients were treated for HPS and met the inclusion criteria. Of these, 56 males and 4 females with an average age of 38±14 days at surgery were included. No differences were found in terms of the duration of surgery, post-operative complications, duration of hospitalization, and weight at the time of surgery. The only statistically significant data was the chlorine level in cases with and without post-operative vomiting (97±3.5 vs. 102±3.3 mmol/L, p<0.05). There was a lower incidence of HPS from 2014 to 2019; however, there was no significant evidence regarding the correlation between this and the reduced birth rate recorded in the province of Verona during the same period.
Conclusion
Although laparoscopic pyloromyotomy is a highly complex procedure, it is a feasible alternative to the classic open technique.
2.Hypertrophic Pyloric Stenosis: 10 Years' Experience with Standard Open and Laparoscopic Approach
Nicola ZAMPIERI ; Valentina CORATO ; Gabriella SCIRÈ ; Francesco Saverio CAMOGLIO
Pediatric Gastroenterology, Hepatology & Nutrition 2021;24(3):265-272
Purpose:
Hypertrophic pyloric stenosis (HPS) is the most common cause of gastric obstruction in newborns. Extra-mucosal pyloromyotomy can be performed through a small laparotomy or laparoscopy. The aim of this study was to compare the two surgical techniques.We also analyzed the incidence of HPS in infants in the last 10 years in relation to the demographic trend of our province.
Methods:
We analyzed all the cases of HPS treated at our Unit between January 2010 and December 2019. The data were obtained from operating systems. Data about the demographic trends, in particular, the number of births and the population residing in the province of Verona from 2010 to 2019, were also retrieved.
Results:
During the study period, 60 patients were treated for HPS and met the inclusion criteria. Of these, 56 males and 4 females with an average age of 38±14 days at surgery were included. No differences were found in terms of the duration of surgery, post-operative complications, duration of hospitalization, and weight at the time of surgery. The only statistically significant data was the chlorine level in cases with and without post-operative vomiting (97±3.5 vs. 102±3.3 mmol/L, p<0.05). There was a lower incidence of HPS from 2014 to 2019; however, there was no significant evidence regarding the correlation between this and the reduced birth rate recorded in the province of Verona during the same period.
Conclusion
Although laparoscopic pyloromyotomy is a highly complex procedure, it is a feasible alternative to the classic open technique.
3.Quality of Life and Anorectal Malformations: A Single-Center Experience
Gabriella SCIRÈ ; Riccardo GABALDO ; Ilaria DANDO ; Francesco S. CAMOGLIO ; Nicola ZAMPIERI
Pediatric Gastroenterology, Hepatology & Nutrition 2022;25(4):340-346
Purpose:
The treatment and long term clinical outcomes of anorectal malformations (ARM) in children have always been the focus of pediatric surgeons. This study aimed at reporting our experience as far as long-term follow-up of ARM in children is concern.
Methods:
We enrolled patients treated between 1999 and 2019, and established selection criteria to choose appropriate subjects. A validated questionnaire was used to determine long-term quality of life outcomes.
Results:
Out of a total of 48 patients treated within the study period, 28 were enrolled in this study. Among the latter, more than 35% had at least one long-time complication, and more than 90% had a good lifestyle. Urinary and fecal continence was achieved in more than 95% of the patients using medical devices.
Conclusion
This study aimed to bring up new concepts; taking into consideration all aspects of life in patients with ARM, from school life to sexuality, while evaluating fecal and urinary continence. This is essential for the improvement of the skills of the different specialists involved in the management of these patients, and for the implementation of strategies that can improve postoperative function. Most especially, it will also help improve communication between doctors to ensure an adequate transition of these children into adult life.