{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T15:21:12Z","timestamp":1783005672678,"version":"3.54.5"},"reference-count":15,"publisher":"Royal College of Surgeons of England","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["annals"],"abstract":"\n Introduction<\/jats:title>\n Infantile hypertrophic pyloric stenosis (IHPS) is a common cause of non-bilious projectile vomiting in early infancy. Although open pyloromyotomy (OPM) remains the standard in many low\u2013middle-income countries (LMICs), laparoscopic pyloromyotomy (LPM) is increasingly favoured in high-income settings for its faster recovery and improved cosmesis. This study compares the feasibility, safety and outcomes of OPM and LPM at Pakistan\u2019s largest public paediatric hospital.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This randomised trial enrolled 60 infants with IHPS allocated to open (OPM, n = 30) or laparoscopic pyloromyotomy (LPM, n = 30). Operative time was measured skin-to-skin, with secondary analysis of pyloromyotomy time. Primary outcomes were operative duration, time to full feeding and postoperative stay.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Total operative time was shorter for OPM (39.3 \u00b1 9.5 vs 56.9 \u00b1 31.2min, p < 0.05). Pyloromyotomy time was also shorter in OPM (29.1 \u00b1 8.2 vs 49.3 \u00b1 32.7min, p < 0.05). However, LPM patients achieved full feeding faster (7.1 \u00b1 1.5 vs 11.2 \u00b1 9.8h, p < 0.05) and had shorter hospital stays (1.4 \u00b1 0.7 vs 2.5 \u00b1 1.9 days, p < 0.05). Complication rates were comparable.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Despite longer operative times, LPM demonstrated significantly better postoperative recovery. With appropriate training and investment, LPM is a feasible and beneficial alternative to OPM in LMIC settings.<\/jats:p>\n <\/jats:sec>","DOI":"10.1308\/rcsann.2026.0066","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T15:10:46Z","timestamp":1783005046000},"source":"Crossref","is-referenced-by-count":0,"title":["A prospective randomised controlled trial comparing open and laparoscopic pyloromyotomy for infantile hypertrophic pyloric stenosis in a low\u2013middle-income country setting"],"prefix":"10.1308","author":[{"given":"S","family":"Ahmad","sequence":"first","affiliation":[{"name":"The Children Hospital & University of Child Health Sciences, Lahore, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N","family":"Talat","sequence":"additional","affiliation":[{"name":"The Children Hospital & University of Child Health Sciences, Lahore, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Rehan","sequence":"additional","affiliation":[{"name":"The Children Hospital & University of Child Health Sciences, Lahore, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MS","family":"Saleem","sequence":"additional","affiliation":[{"name":"The Children Hospital & University of Child Health Sciences, Lahore, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"U","family":"Mahmood","sequence":"additional","affiliation":[{"name":"The Children Hospital & University of Child Health Sciences, Lahore, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"171","published-online":{"date-parts":[[2026,7,2]]},"reference":[{"key":"C1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2007.12.075"},{"key":"C2","first-page":"120","volume":"19","author":"Tadesse A","year":"2014","journal-title":"East Cent Afr J Surg"},{"key":"C3","first-page":"1","volume":"8","author":"Chalya PL","year":"2015","journal-title":"BMC Res Notes"},{"key":"C4","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2272011329"},{"key":"C5","doi-asserted-by":"publisher","DOI":"10.5958\/2394-4994.2016.00003.2"},{"key":"C6","doi-asserted-by":"publisher","DOI":"10.4103\/0971-9261.142009"},{"key":"C7","doi-asserted-by":"publisher","DOI":"10.1007\/BF02653256"},{"key":"C8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2016.05.006"},{"key":"C9","first-page":"e73285","volume":"16","author":"Nadeem A","year":"2024","journal-title":"Cureus"},{"key":"C10","first-page":"7","volume":"2","author":"Khalid K","year":"2021","journal-title":"J Pediatr Adolesc Sur"},{"key":"C11","doi-asserted-by":"publisher","DOI":"10.1038\/ncpgasthep0764"},{"key":"C12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2009.04.001"},{"key":"C13","doi-asserted-by":"publisher","DOI":"10.7602\/jmis.2016.19.1.9"},{"key":"C14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2011.10.026"},{"key":"C15","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000234647.03466.27"}],"container-title":["The Annals of The Royal College of Surgeons of England"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publishing.rcseng.ac.uk\/doi\/pdf\/10.1308\/rcsann.2026.0066","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T15:12:46Z","timestamp":1783005166000},"score":1,"resource":{"primary":{"URL":"https:\/\/publishing.rcseng.ac.uk\/doi\/10.1308\/rcsann.2026.0066"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,2]]},"references-count":15,"alternative-id":["10.1308\/rcsann.2026.0066"],"URL":"https:\/\/doi.org\/10.1308\/rcsann.2026.0066","relation":{},"ISSN":["0035-8843","1478-7083"],"issn-type":[{"value":"0035-8843","type":"print"},{"value":"1478-7083","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,2]]},"article-number":"rcsann.2026.0066"}}