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Cubas RF, Longshore S, Rodriguez S, et al. Atropine: A Cure for Persistent Post Laparoscopic Pyloromyotomy Emesis?. J Neonatal Surg. 2017;6(1):2doi: 10.21699/jns.v6i1.485.
Cubas, R. F., Longshore, S., Rodriguez, S., Tagge, E., Baerg, J., & Moores, D. (2017). Atropine: A Cure for Persistent Post Laparoscopic Pyloromyotomy Emesis?. Journal of neonatal surgery, 6(1), 2. https://doi.org/10.21699/jns.v6i1.485
Cubas, Robert Frank, et al. "Atropine: A Cure for Persistent Post Laparoscopic Pyloromyotomy Emesis?." Journal of neonatal surgery vol. 6,1 (2017): 2. doi: https://doi.org/10.21699/jns.v6i1.485
Cubas RF, Longshore S, Rodriguez S, Tagge E, Baerg J, Moores D. Atropine: A Cure for Persistent Post Laparoscopic Pyloromyotomy Emesis?. J Neonatal Surg. 2017 Jan 01;6(1):2. doi: 10.21699/jns.v6i1.485. eCollection 2017. PMID: 28083488; PMCID: PMC5224753.
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J Neonatal Surg. 2017 Jan 01;6(1):2. doi: 10.21699/jns.v6i1.485. eCollection 2017.

Atropine: A Cure for Persistent Post Laparoscopic Pyloromyotomy Emesis?.

Journal of neonatal surgery

Robert Frank Cubas, Shannon Longshore, Samuel Rodriguez, Edward Tagge, Joanne Baerg, Donald Moores

Affiliations

  1. Department of Surgery, Loma Linda University Medical Center, Loma Linda, CA, USA.
  2. Division of Pediatric Surgery, Loma Linda University Children's Hospital, Loma Linda, CA, USA.

PMID: 28083488 PMCID: PMC5224753 DOI: 10.21699/jns.v6i1.485

Abstract

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.

Keywords: Atropine; Post-pyloromyotomy emesis; Pyloric stenosis

References

  1. Surg Endosc. 2004 Jun;18(6):907-9 - PubMed
  2. J Pediatr Surg. 2007 Apr;42(4):692-8 - PubMed
  3. J Pediatr Surg. 2012 Jan;47(1):93-8 - PubMed
  4. J Pediatr Surg. 2006 Oct;41(10):1676-8 - PubMed
  5. J Pediatr Surg. 2000 Feb;35(2):338-41; discussion 342 - PubMed
  6. BMJ Case Rep. 2012 Aug 02;2012:null - PubMed
  7. Pediatr Int. 2013 Aug;55(4):488-91 - PubMed
  8. J Pediatr Surg. 2005 Dec;40(12):1848-51 - PubMed
  9. Pediatr Surg Int. 2006 Dec;22(12):1021-4 - PubMed
  10. Surg Endosc. 1998 Jun;12(6):813-5 - PubMed
  11. Acta Paediatr. 2014 Feb;103(2):e84-7 - PubMed

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