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Association of Paediatric Surgeons of Bangladesh
Journal of Paediatric Surgeons of Bangladesh
Original Articles · Vol. 1 No. 1 (2010)

A Prospective Comparative Study of the Outcome of Double-Y Pyloromyotomy (Alayet's Pyloromyotomy) and Ramstedt's Pyloromyotomy for the Surgical Management of Infantile Hypertrophic Pyloric Stenosis

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JPSB
Journal of
Paediatric Surgeons of Bangladesh
Published : January 2010
CONTENTSVolume 01Number 1January 2010
Editorial
Pediatric Surgery – Challenging Speciality in SAARC Region
Devendra K Gupta
03
Review Articles
Revival of Landing's Concept of Infantile Obstructive Cholangiopathy – A Plea to Hand Over the 2 Week Old Jaundiced Full Term Neonate to the Surgeon!
Shilpa Sharma, Devendra K Gupta
37
Postoperative Results Following Surgery for PUJO in Children
Prabudh Goel, Devendra K Gupta
53
Original Articles
Laparoscopically Assisted Anorectoplasty Using Perineal Ultrasonographic Guide
Akio Kubota
06
Laparoscopic Pyeloplasty - Our Early Experience
Gazi Mohammad Zakir Hossain, Mofizur Rahman, Rashedul Hasan
10
A Prospective Comparative Study of the Outcome of Double-Y Pyloromyotomy (Alayet's Pyloromyotomy) and Ramstedt's Pyloromyotomy for the Surgical Management of Infantile Hypertrophic Pyloric Stenosis
Md. Ansar Ali, Md. Sharifuzzaman, Md. Ashraf Ul Huq, Md. Mahbub-Ul Alam
15
Extradural Haematoma in Children: Surgical Experiences and Prospective Analysis of 138 Cases
Sharif Md. Noman Khaled Chowdhury, Abdul Hanif, K M Tarikul Islam, Ehsan Mahmud, Sk. Sader Hossain
19
Evaluation of the Outcome of IRPG 910 and Polypropylene in Terms of Cosmesis and Cost for Skin Closure in Cleft lip Surgery
Md. Akbar Hossain Bhuiyan, Shahanara Chowdhury, Shafiqul Hoque
25
Neonatal Surgery: Demand and Survival Both are Increasing: Eight Years Experience in Dhaka Medical College Hospital, Bangladesh
Abdul Hanif, Kaniz Hasina, Ahmed Zahid Hossain, S M Shamsul Huda, M Kamrul Hassan, Md. Mahbub-Ul Alam, AKM Zahid Hossain
30
Miscellaneous
Neonatal Surgery
Anette Jacobsen
65
Case Reports
Mayer-Rokitansky-Kuster-Hauser (MRKH) Syndrome – A Case Report
Md. Kabirul Islam, Md. Shah Alam, Abdul Hanif, Md. Kamrul Hasan, Mizanur Rahman
70
Endoscopic Removal of Vesical Calculus Through Suprapubic Route: A Case Report
Md. Akbar Hossain Bhuyian, Md. Ashraf Ul Huq, Mahfuzul Kabir, Shafquat Haider Chowdhury
74
Two Case Reports of Peutz Jegher's Syndrome
Abdul Hanif, Kaniz Hasina, Md. Kamrul Hassan, Shah Alam Talukder, Md. Kabirul Islam
77
Ambiguous Genitalia with Perineal Rhabdomyosarcoma: A Case Report
Tahmina Banu, Tanvir Kabir Chowdhury, Md. Mozammel Hoque
80
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ASSOCIATION OF PAEDIATRIC SURGEONS OF BANGLADESH (APSB)
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Authors

  • Md. Ansar Ali3rd Part Student, Dept. of Pediatric Surgery, Dhaka Medical College Hospital, Dhaka
  • Md. Sharifuzzaman3rd Part Student, Dept. of Pediatric Surgery, Dhaka Medical College Hospital, Dhaka
  • Md. Ashraf Ul HuqAssociate Professor, Dept. of Pediatric Surgery, Dhaka Medical College Hospital, Dhaka
  • Md. Mahbub-Ul AlamProfessor & Head, Dept. of Pediatric Surgery, Dhaka Medical College Hospital, Dhaka

Keywords

Pyloric Stenosis pyloromyotomy double-Y pyloromyotomy Alayet’s pyloromyotomy

Abstract

Background: Many innovations and approaches have been tried for the surgical management of Infantile Hypertrophic Pyloric Stenosis (IHPS) since Ramstedt’s first successful surgery almost one hundred years ago. Here a new technique focusing on the pylorus which may offer better results for this common condition. Methods: A prospective on going study of 20 patients with IHPS are carried out over a period of 15 months from July 2008 to September 2009. The patients are divided into 2 equal groups of 10 patients in each. The study is designed that all patients selected for study are optimized preoperatively with regard to hydration, acid-base status and electrolytes imbalance. All surgeries are performed after obtaining informed consent. Standard preoperative preparation and postoperative feeding regimes are used. The patients are operated on an alternate basis, i.e., one patient by double-Y pyloromyotomy (DY) and the next by a Ramstedt’s pyloromyotomy (RP). Data on patient demographics, operative time, anesthesia complications, Postoperative complications including vomiting and weight gain are collected. Patients are followed up for a period of 3 months postoperatively. Statistical assessments are done by using Student test. Results: No statistical differences are observed in patient population regarding age, sex, weight at presentation, symptoms and clinical condition including electrolytes imbalance and acid-base status. Significant differences are found in postoperative vomiting and weight gain. Data of post operative vomiting and weight gain in both groups are collected. Vomiting in double-Y (DY) pyloromyotomy group (1.23 ± 0.98 days) vs Ramstedt’s pyloromyotomy (RP) group (2.95 ± 0.99 days) p= 0.0094. Weight gain after 1st 10 days DY vs RP is (298 ± 57.94 gm vs 193 ± 19.8 gm p=0.0014), after 1 month (685 ± 15.72 gm vs 498 ± 12.36 gm, p=0.0008), after 2 months (670 ± 105.93 gm vs 455 ± 79.76 gm, p=0.00013) and after 3 months (555 ± 86.44 gm vs 435 ± 47.43 gm, p=0.00098). No long-term complications are reported and no re-do pyloromyotomy is needed. Conclusion: The double-Y pyloromyotomy seems to be a better technique for the surgical management of IHPS. It may offer a better functional outcome in term of postoperative vomiting and weight gain.

Journal of Paediatric Surgeons of Bangladesh (2010) Vol. 1 (1): 15–18

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