Ad libitum feeds after laparoscopic pyloromyotomy:: A retrospective comparison with a standardized feeding regimen in 227 infants

被引:18
作者
Adibe, Obinna O. [1 ]
Nichol, Peter F. [1 ]
Lim, Foong-Yen [1 ]
Mattei, Peter [1 ]
机构
[1] Childrens Hosp Philadelphia, Philadelphia, PA 19104 USA
来源
JOURNAL OF LAPAROENDOSCOPIC & ADVANCED SURGICAL TECHNIQUES | 2007年 / 17卷 / 02期
关键词
D O I
10.1089/lap.2006.0143
中图分类号
R61 [外科手术学];
学科分类号
摘要
Purpose: The best feeding regimen after pyloromyotomy for hypertrophic pyloric stenosis continues to be a topic of some debate. Postoperative emesis and length of hospital stay are principal concerns. We compared the outcome of infants after laparoscopic pyloromyotomy who were fed using a standardized feeding regimen or ad libitum. Materials and Methods: We reviewed the records of 227 infants who underwent laparoscopic pyloromyotomy within a 5-year period. We compared two sets of patients: those fed using a standardized reeding regimen and those fed ad libitum. The choice of feeding regimen was based solely on the attending surgeon's preference. Each group was examined for frequency of postoperative emesis, time to full feeds, and length of hospital stay. Results: Of the 227 patients in the study, 170 (74.9%) were fed using the standardized feeding regimen and 57 (25.1%) were fed ad libitum. The two groups were comparable with respect to age and sex distribution. Although children fed ad libitum had a significantly shorter time to full feeds that those fed a standardized feeding regimen (19.0 vs. 23.1 hours; P < 0.01), there was no significant difference in the frequency of postoperative emesis (1.8 vs. 1.9 times per patient; P = 0.68) or total length of hospital stay (49.0 vs. 50.3 hours; P = 0.73) when the ad libitum and standardized feed groups were compared. There were no complications in either group. Conclusion: A standardized feeding regimen offers no advantage over ad libitum feeds for infants who have undergone laparoscopic pyloromyotomy. Infants fed ad libitum are able to tolerate full feeds sooner and the frequency of postoperative emesis is not increased. Ad libitum feeding has become the standard postoperative feeding regimen for infants who have undergone pyloromyotomy at our hospital.
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页码:235 / 237
页数:3
相关论文
共 10 条
[1]   EXTRAMUCOSAL PYLOROTOMY BY LAPAROSCOPY [J].
ALAIN, JL ;
GROUSSEAU, D ;
TERRIER, G .
JOURNAL OF PEDIATRIC SURGERY, 1991, 26 (10) :1191-1192
[2]   Postoperative ad lib feeding for hypertrophic pyloric stenosis [J].
Carpenter, RO ;
Schaffer, RL ;
Maeso, CE ;
Sasan, F ;
Nuchtern, JG ;
Jaksic, T ;
Harberg, FJ ;
Wesson, DE ;
Brandt, ML .
JOURNAL OF PEDIATRIC SURGERY, 1999, 34 (06) :959-961
[3]   EARLY POSTOPERATIVE FEEDING - A CONTINUING CONTROVERSY IN PYLORIC-STENOSIS [J].
FOSTER, ME ;
LEWIS, WG .
JOURNAL OF THE ROYAL SOCIETY OF MEDICINE, 1989, 82 (09) :532-533
[4]   Ad libitum feeding decreases hospital stay for neonates after pyloromyotomy [J].
Garza, JJ ;
Morash, D ;
Dzakovic, A ;
Mondschein, JK ;
Jaksic, T .
JOURNAL OF PEDIATRIC SURGERY, 2002, 37 (03) :493-495
[5]   AN ANALYSIS OF FEEDING REGIMENS AFTER PYLOROMYOTOMY FOR HYPERTROPHIC PYLORIC-STENOSIS [J].
GEORGESON, KE ;
CORBIN, TJ ;
GRIFFEN, JW ;
BREAUX, CW .
JOURNAL OF PEDIATRIC SURGERY, 1993, 28 (11) :1478-1480
[6]   Ad libitum feeding: Safely improving the cost-effectiveness of pyloromyotomy [J].
Puapong, D ;
Kahng, D ;
Ko, A ;
Applebaum, H .
JOURNAL OF PEDIATRIC SURGERY, 2002, 37 (12) :1667-1668
[7]  
SCHARLI AF, 1968, SURGERY, V64, P1133
[8]  
TURNOCK R R, 1991, Journal of the Royal College of Surgeons of Edinburgh, V36, P164
[9]   Early feeding after laparoscopic pyloromyotomy - The pros and cons [J].
van der Bilt, JDW ;
Kramer, WLM ;
van der Zee, DC ;
Bax, NMA .
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2004, 18 (05) :746-748
[10]   FEEDING REGIMENS AFTER PYLOROMYOTOMY [J].
WHEELER, RA ;
NAJMALDIN, AS ;
STOODLEY, N ;
GRIFFITHS, DM ;
BURGE, DM ;
ATWELL, JD .
BRITISH JOURNAL OF SURGERY, 1990, 77 (09) :1018-1019