RAMSTEDTS PYLOROMYOTOMY - A SPECIALIST PROCEDURE

One hundred and twenty infants with infantile hypertrophic pyloric ste nosis were operated on by two consultant general surgeons over a 13-ye ar period. General anaesthetic and a standard surgical approach was us ed in all cases. No mortality was recorded and there were no wound deh iscences. The overall postoperative wound infection rate was 9.2%. Pri or to 1985 the infection rate was 15%. Following attention to a number of details including care of the umbilicus, the incidence decreased a fter 1985 to 4%. The most common postoperative complication was vomiti ng, which occurred in 25% of infants. There was one negative laparotom y in the 13-year study period. Two children required a second procedur e for persistent vomiting. The argument in favour of specialisation in managing this condition is questioned along with the need for intensi ve diagnostic investigation.