Correctness of Alayet's demand on the Double-Y pyloromyotomy as a novel surgical technique approaching infantile hypertrophic stenosis

Dear Editor,

The authors of this Letter were surprised reading the article by Y. F. Alalayet et al. mentioned above, which was recently published. The technique described in this article has been used in our Division since the middle of the nineties, i. e., since than 10 years! To our knowledge, the original article on this well established procedure was first published by S. K. Ohri et al. in 1991 [1]. The group described the postoperative outcome after a modified Ramstedt's procedure in a case series of 37 patients. According to the study results, there was no mortality and no intraoperative mucosal injury but, simultaneously, a reduced rate of postoperative vomiting. Even taking into account that the procedure had not been commonly accepted at that time – “Why make an easy operation difficult?” [2] – it has achieved full acceptance as a standard procedure in our group. Taken together, the reporting authors do not share the opinion that the described procedure can be considered a “new technique”. In addition, we disapprove of the designation as “Alayet`s pyloromyotomy” since it does not honor the actual first report by OhriŽs group. We would be glad and grateful if our comments initiate a discussion on the subject in the “community of pediatric surgeons” [Fig. 1]

Fig. 1 Copy of the original drawing out of the article by Ohri et al. [1].

References

• 1 Ohri SK, Sackier JM, Singh P. Modified Ramstedt`s pyloromyotomy for the treatment of infantile hypertrophic pyloric stenosis”.  JR Coll Surg Edinb. 1991;  36 94-96
• 2 Scorpio RJ, Beasley SW. Pyloromyotomy: why make an easy operation difficult?.  JR Coll Surg Edinb. 1993;  38 299-301