Atropine: A Cure for Persistent Post Laparoscopic Pyloromyotomy Emesis?
Background: Atropine has been used as a successful primary medical treatment for hypertrophic pyloric stenosis. Several authors have reported a higher rate of incomplete pyloromyotomy with the laparoscopic approach compared to open. In this study, we evaluated the use of atropine as a medical treatm...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
EL-Med-Pub
2016-12-01
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| Series: | Journal of Neonatal Surgery |
| Subjects: | |
| Online Access: | https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/465 |
| _version_ | 1818360598159687680 |
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| author | Robert Frank Cubas Shannon Longshore Samuel Rodriguez Edward Tagge Joanne Baerg Donald Moores |
| author_facet | Robert Frank Cubas Shannon Longshore Samuel Rodriguez Edward Tagge Joanne Baerg Donald Moores |
| author_sort | Robert Frank Cubas |
| collection | DOAJ |
| description | Background: Atropine has been used as a successful primary medical treatment for hypertrophic pyloric stenosis. Several authors have reported a higher rate of incomplete pyloromyotomy with the laparoscopic approach compared to open. In this study, we evaluated the use of atropine as a medical treatment for infants with emesis persisting greater than 48 hours after a laparoscopic pyloromyotomy.
Materials and Methods: We performed a retrospective chart review of infants receiving a laparoscopic pyloromyotomy between November 1998 and November 2012. Infants with emesis that persisted beyond 48 hours postoperatively were given 0.01mg/kg of oral atropine 10 minutes prior to feeding. Infants remained inpatient until they tolerated two consecutive feedings without emesis.
Results: 965 patients underwent laparoscopic pyloromyotomy; 816 (84.6%) male and 149 (15.4%) female. Twenty-four (2.5%) received oral atropine. The mean length of stay for patients who received atropine was 5.6 ± 2.6 days, an average of 3 additional days. They were discharged home with a one-month supply of oral atropine. Follow up evaluation did not reveal any complications from receiving atropine. The median follow up was 21 days. None returned to the operating room for incomplete pyloromyotomy. There were 17 (1.8%) operative complications in our series; 9 mucosal perforations, 2 duodenal perforations, and 6 conversions to open for equipment failure or poor exposure. There were 4 (0.4%) post-operative complications: 2 episodes of apnea requiring reintubation and 2 incisional hernias that required a second operation. There were no deaths.
Conclusion: Oral atropine is a viable treatment for persistent emesis after a pyloromyotomy and reduces the need for a second operation due to incomplete pyloromyotomy. |
| first_indexed | 2024-12-13T21:03:20Z |
| format | Article |
| id | doaj.art-099139f1882f421a946178e5b44f6c76 |
| institution | Directory Open Access Journal |
| issn | 2226-0439 |
| language | English |
| last_indexed | 2024-12-13T21:03:20Z |
| publishDate | 2016-12-01 |
| publisher | EL-Med-Pub |
| record_format | Article |
| series | Journal of Neonatal Surgery |
| spelling | doaj.art-099139f1882f421a946178e5b44f6c762022-12-21T23:31:32ZengEL-Med-PubJournal of Neonatal Surgery2226-04392016-12-016110.21699/jns.v6i1.485Atropine: A Cure for Persistent Post Laparoscopic Pyloromyotomy Emesis?Robert Frank Cubas0Shannon Longshore1Samuel Rodriguez2Edward Tagge3Joanne Baerg4Donald Moores5Loma Linda University Medical CenterLoma Linda University Children's HospitalLoma Linda University Medical CenterLoma Linda University Children's HospitalLoma Linda University Children's HospitalLoma Linda University Children's HospitalBackground: Atropine has been used as a successful primary medical treatment for hypertrophic pyloric stenosis. Several authors have reported a higher rate of incomplete pyloromyotomy with the laparoscopic approach compared to open. In this study, we evaluated the use of atropine as a medical treatment for infants with emesis persisting greater than 48 hours after a laparoscopic pyloromyotomy. Materials and Methods: We performed a retrospective chart review of infants receiving a laparoscopic pyloromyotomy between November 1998 and November 2012. Infants with emesis that persisted beyond 48 hours postoperatively were given 0.01mg/kg of oral atropine 10 minutes prior to feeding. Infants remained inpatient until they tolerated two consecutive feedings without emesis. Results: 965 patients underwent laparoscopic pyloromyotomy; 816 (84.6%) male and 149 (15.4%) female. Twenty-four (2.5%) received oral atropine. The mean length of stay for patients who received atropine was 5.6 ± 2.6 days, an average of 3 additional days. They were discharged home with a one-month supply of oral atropine. Follow up evaluation did not reveal any complications from receiving atropine. The median follow up was 21 days. None returned to the operating room for incomplete pyloromyotomy. There were 17 (1.8%) operative complications in our series; 9 mucosal perforations, 2 duodenal perforations, and 6 conversions to open for equipment failure or poor exposure. There were 4 (0.4%) post-operative complications: 2 episodes of apnea requiring reintubation and 2 incisional hernias that required a second operation. There were no deaths. Conclusion: Oral atropine is a viable treatment for persistent emesis after a pyloromyotomy and reduces the need for a second operation due to incomplete pyloromyotomy.https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/465Pyloric stenosisAtropinePost-pyloromyotomy emesis |
| spellingShingle | Robert Frank Cubas Shannon Longshore Samuel Rodriguez Edward Tagge Joanne Baerg Donald Moores Atropine: A Cure for Persistent Post Laparoscopic Pyloromyotomy Emesis? Journal of Neonatal Surgery Pyloric stenosis Atropine Post-pyloromyotomy emesis |
| title | Atropine: A Cure for Persistent Post Laparoscopic Pyloromyotomy Emesis? |
| title_full | Atropine: A Cure for Persistent Post Laparoscopic Pyloromyotomy Emesis? |
| title_fullStr | Atropine: A Cure for Persistent Post Laparoscopic Pyloromyotomy Emesis? |
| title_full_unstemmed | Atropine: A Cure for Persistent Post Laparoscopic Pyloromyotomy Emesis? |
| title_short | Atropine: A Cure for Persistent Post Laparoscopic Pyloromyotomy Emesis? |
| title_sort | atropine a cure for persistent post laparoscopic pyloromyotomy emesis |
| topic | Pyloric stenosis Atropine Post-pyloromyotomy emesis |
| url | https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/465 |
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