Shannon N Acker1, Allan J Garcia, James T Ross, Stig Somme. 1. Department of Pediatric Surgery, Children's Hospital Colorado, University of Colorado School of Medicine, 12631 E 17th Ave, C302, Aurora, CO, 80045, USA, Shannon.acker@ucdenver.edu.
Abstract
AIM: We hypothesized that recent trends towards earlier diagnosis of hypertrophic pyloric stenosis continued throughout the early part of the 21st century. METHODS: We reviewed the medical records of patients with HPS at a single institution during two periods: 1/03-12/05 and 4/09-7/13. RESULTS: A total of 433 patients with hypertrophic pyloric stenosis who underwent pyloromyotomy were included (modern cohort = 259; historic = 174). The two cohorts did not differ in terms of age, weight, or median time from symptom onset to physician (5 vs 6.5 days; p = 0.3) or surgeon (7 days for both) evaluation. The percentage of patients who presented late (>7 days of symptoms) (27 % modern vs 25 % historic; p = 0.15) or with an elevated serum bicarbonate (22 % for both; p = 0.8) did not change over time. There was a shift to laparoscopic procedures: 99 % modern vs 57 % historic (p < 0.0001) with no associated change in operative length (28 vs. 27 min; p = 0.06), or operative (3 % for both, p = 0.8) or respiratory (4 vs 2 %, p = 0.4) complications. CONCLUSION: Most infants with hypertrophic pyloric stenosis are diagnosed early, prior to significant electrolyte abnormalities; however, continued improvement in awareness is necessary given that a fourth of patients are diagnosed after over 1 week of symptoms.
AIM: We hypothesized that recent trends towards earlier diagnosis of hypertrophic pyloric stenosis continued throughout the early part of the 21st century. METHODS: We reviewed the medical records of patients with HPS at a single institution during two periods: 1/03-12/05 and 4/09-7/13. RESULTS: A total of 433 patients with hypertrophic pyloric stenosis who underwent pyloromyotomy were included (modern cohort = 259; historic = 174). The two cohorts did not differ in terms of age, weight, or median time from symptom onset to physician (5 vs 6.5 days; p = 0.3) or surgeon (7 days for both) evaluation. The percentage of patients who presented late (>7 days of symptoms) (27 % modern vs 25 % historic; p = 0.15) or with an elevated serum bicarbonate (22 % for both; p = 0.8) did not change over time. There was a shift to laparoscopic procedures: 99 % modern vs 57 % historic (p < 0.0001) with no associated change in operative length (28 vs. 27 min; p = 0.06), or operative (3 % for both, p = 0.8) or respiratory (4 vs 2 %, p = 0.4) complications. CONCLUSION: Most infants with hypertrophic pyloric stenosis are diagnosed early, prior to significant electrolyte abnormalities; however, continued improvement in awareness is necessary given that a fourth of patients are diagnosed after over 1 week of symptoms.
Authors: Emma V Carrington; Nigel J Hall; Maurizio Pacilli; David P Drake; Joseph I Curry; Edward M Kiely; Paolo De Coppi; Agostino Pierro; Simon Eaton Journal: J Surg Res Date: 2012-03-27 Impact factor: 2.192
Authors: Nigel J Hall; Maurizio Pacilli; Simon Eaton; Kim Reblock; Barbara A Gaines; Aimee Pastor; Jacob C Langer; Antti I Koivusalo; Mikko P Pakarinen; Lutz Stroedter; Stefan Beyerlein; Munther Haddad; Simon Clarke; Henri Ford; Agostino Pierro Journal: Lancet Date: 2009-01-18 Impact factor: 79.321