Efficacy and safety of laparoscopic pyloromyotomy and open pyloromyotomy for the treatment of congenital hypertrophic pyloric stenosis:Meta analysis / 中华实用儿科临床杂志

ABSTRACT

Objective To evaluate the efficacy and safety of laparoscopic pyloromyotomy (LP) or open pyloromyotomy (OP) for the treatment of congenital hypertrophic pyloric stenosis(CHPS),and to provide a basis for reasonable treatment programme for clinic.Methods Randomized control trials (RCTs) about LP and OP for the treatment of CHPS were searched using Cochrane library,PubMed,Embase,Cumulative Index To Nursing And Allied Health Literature (CINAHL),Web of Science,Chinese biomedical literature database and China National Knowledge Internet database.Study selection and Meta analysis were conducted according to the Cochrane Handbook for systematic reviews.Extracted data from the selected studies were reviewed by the reviewers and analyzed using RevMan 5.1 software.Results Five RCTs with a total of 552 patients fulfilled the inclusion criteria and were analyzed in this review.Meta analysis showed that there was no statistically significant differences in incidence of postoperative complications between LP and OP (OR =2.59,95 ％ CI0.90-7.47).Compared with OP,the postoperative recovery eating time and postoperative hospital stay in patient with LP were significantly reduced (MD =-3.63,95％ CI-5.19--2.06) ;MD =-12.62,95 ％ CI-16.13--9.11).Conclusions LP result in earlier feeding,shorter hospital stay,less trauma with superior cosmetic outcome and earlier recovery of the patient than the OP.But the postoperative complication between the two surgeries still remains the topic of concern.