BACKGROUND: Despite good surgical results from right transverse hypochondrial incisions for Ramstedt's pyloromyotomies, children remain concerned by the presence of an obvious and permanent scar. The aim of this study is to compare the results of two approaches. METHODS: Forty-eight infants underwent a Ramstedt pyloromyotomy for infantile hypertrophic pyloric stenosis. To facilitate the delivery of the pyloric mass, 22 patients were operated on via a standard right transverse hypochondrial incision and 26 patients via a circumumbilical incision with or without lateral wound extension. These two group were compared retrospectively. RESULTS: The groups did not differ significantly with respect to the length of the hospital stay or the perioperative complications. The circumumbilical incision with lateral wound extension allowed easy access to the pyloric mass without conversion of incisions due to inadequate exposure. All circumumbilical incisions healed well, resulting in an apparently unscarred abdomen. The final good cosmetic result of the circumumbilical incision satisfied all parents. CONCLUSIONS: We propose the circumumbilical incision as an alternative to be used in the operative approach to the pylorus in the treatment of infantile hypertrophic pyloric stenosis.
Abdomen ; Child ; Cicatrix ; Humans ; Infant ; Length of Stay ; Parents ; Pyloric Stenosis, Hypertrophic ; Pylorus ; Retrospective Studies ; Wounds and Injuries

No abstract available.
Aneurysm, Dissecting/diagnosis/*etiology/physiopathology/therapy ; Anticoagulants/therapeutic use ; Aortic Aneurysm/diagnosis/*etiology/physiopathology/therapy ; Behcet Syndrome/*complications/diagnosis/drug therapy ; Cerebral Infarction/diagnosis/etiology ; Diffusion Magnetic Resonance Imaging ; Echocardiography, Doppler, Color ; Electrocardiography ; Hemodynamics ; Humans ; Immunosuppressive Agents/therapeutic use ; Male ; Middle Aged ; *Sinus of Valsalva/physiopathology/ultrasonography ; Thrombosis/diagnosis/drug therapy/*etiology/physiopathology ; Ventricular Septal Rupture/diagnosis/*etiology/physiopathology/therapy

PURPOSE: Although upper airway cough syndrome (UACS) is one of the most common causes of chronic cough, there are few reports on the effects of intranasal steroids (INS) on improvement of cough in patients with chronic cough caused by UACS. Here, we observed improvement in cough depending on prescribed medications, including INS, in patients with chronic cough caused exclusively by UACS in the clinical setting. METHODS: Patients with chronic cough caused exclusively by UACS were selected by the retrospective review of medical records. Durations and kinds of prescribed medications, nasal and postnasal drip symptoms, and results of paranasal sinus series at first visit were evaluated. According to the improvement of cough at the second visit, the patients were divided into the improved and unimproved groups. Odds ratios of each medication in the improved group were analyzed by logistic regression adjusted for age, sex, smoking history, duration of treatment, prescriptions of medications, presence of nasal and postnasal drip symptoms, and results of paranasal sinus series. RESULTS: A total of 122 patients with chronic cough caused exclusively by UACS were comprised of 38 patients in the improved group and 84 patients in the unimproved group. INS were prescribed to 45 patients, and the number of patients with INS prescription were significantly higher in the unimproved group than that in not-improved group (55.3% vs. 28.6%, P=0.008). The odds ratio of INS prescription was significantly higher in the improved group (odds ratio, 4.78; 95% confidence interval, 1.03-22.3; P=0.046). CONCLUSION: INS could improve cough symptom in patients with UACS. These results warrant further evaluation.
Administration, Intranasal ; Cough* ; Humans ; Logistic Models ; Medical Records ; Odds Ratio ; Prescriptions ; Retrospective Studies ; Sinusitis ; Smoke ; Smoking ; Steroids*