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J Pediatr Surg. 2008 Oct;43(10):1802-6. doi: 10.1016/j.jpedsurg.2008.02.066.

Circumumbilical pyloromyotomy in the era of minimally invasive surgery.

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Pediatric Surgery Unit, University of Rome La Sapienza, Azienda Policlinico Umberto I, Rome, RM 00161, Italy.



No studies have investigated the cosmetic outcome of current approaches to pyloromyotomy in infants with hypertrophic pyloric stenosis. The purpose of this study was to evaluate the final appearance of the scar in patients undergoing circumumbilical pyloromyotomy.


During a 16-year period, 86 infants underwent circumumbilical pyloromyotomy at our institution. A detailed questionnaire was created to document the family members' perceptions of the esthetic appearance of the scar. Data were collected by telephone interview and at clinic visit. In addition, cosmesis was assessed by 5 staff members who scored blindly the esthetic outcome of the scars with comparative photographs, using a categorical scale.


Fifty-seven families were tracked by telephone contact. In the family questionnaire, 100% of families reported an excellent or good scar. Of these, forty-one (72%) were available for cosmetic assessment. Follow-up ranged between 5 months and 15 years (mean, 6 years). The panel members ranked the scar, on average, as excellent or good for 90% of the patients. No assessor stated that a scar was unacceptable. Intra- and interobserver agreement was 0.72 and 0.78, respectively.


Overall satisfaction with the cosmetic outcome of circumumbilical pyloromyotomy is very high.

[Indexed for MEDLINE]

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