Laparoscopic pyloromyotomy: effect of resident training on complications

Journal of Pediatric Surgery
Ramanath N HaricharanDouglas C Barnhart

Abstract

The purpose of this study was to characterize the safety of laparoscopic pyloromyotomy and examine the effect of resident training on the occurrence of complications. Five hundred consecutive infants who underwent laparoscopic pyloromyotomy between January 1997 and December 2005 were reviewed and analyzed. Laparoscopic pyloromyotomy was successfully completed in 489 patients (97.8%). Four hundred seventeen patients were boys (83%). Intraoperative complication occurred in 8 (1.6%) patients (mucosal perforation, 7; serosal injury to the duodenum, 1). All were immediately recognized and uneventfully repaired. Six patients (1.2%) required revision pyloromyotomy for persistent or recurrent gastric outlet obstruction. There were 7 wound complications (1.4%) and no deaths. Pediatric surgery residents performed 81% of the operations, whereas 16% were done by general surgery residents (postgraduate years 3-4). There was a 5.4-fold increased risk of mucosal perforation or incomplete pyloromyotomy when a general surgery resident rather than a pediatric surgery resident performed the operation (95% confidence interval, 1.8-15.8; P = .003). These effects persisted even after controlling for weight, age, and attending experience. The laparos...Continue Reading

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Citations

Jul 16, 2010·Pediatric Surgery International·Satoshi IeiriTomoaki Taguchi
Jan 15, 2014·Journal of Surgical Education·Mauricio A EscobarLaurence B McCullough
Mar 13, 2013·The Journal of Surgical Research·Theresa R HarringChristine A O'Mahony
Apr 14, 2009·Journal of Pediatric Surgery·Omar Yusef KudsiB Randall Brenn
Aug 12, 2015·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Michimasa FujiogiTadashi Iwanaka
Jun 24, 2014·Journal of Pediatric Surgery·Nigel J HallAgostino Pierro
Nov 4, 2020·La Pediatria medica e chirurgica : Medical and surgical pediatrics·Salvatore Fabio ChiarenzaMaria Mendoza-Sagaon
Jan 22, 2009·Lancet·Aydin Yagmurlu

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