Abstract：
The aim of this study was to compare the operative parameters and complication rates between the umbilical (UMB) and right upper quadrant (RUQ) skin incisions for Ramstedt\'s pyloromyotomy for the treatment of infantile hypertrophic pyloric stenosis (IHPS). PubMed, EMBASE, Web of Science and Scopus databases were systematically searched. The studies where any one of the main outcomes of interest, i.e., operative time, wound infection rate, mucosal perforation rate were reported were eligible for inclusion. The statistical analysis was performed using a random-effects model. The methodological quality of the studies was assessed utilizing the Newcastle-Ottawa Scale. Fifteen studies comprising 2964 infants were included. As compared to the UMB group, the RUQ group showed a significantly lower mean operative time (p = 0.0004), wound infection rate (p < 0.0001) and mucosal perforation rate (p = 0.02). Although UMB incision produces an almost undetectable scar, this approach results in significantly more complications. Therefore, the risks and benefits must be weighed and discussed with the caregivers in deciding the surgical approach in patients with IHPS. However, due to a poor methodological quality of nine out of fifteen studies, further studies need to be conducted for an optimal comparison between the two groups.
摘要：
这项研究的目的是比较Ramstedt幽门切开术治疗婴儿肥厚性幽门狭窄（IHPS）的脐带（UMB）和右上腹（RUQ）皮肤切口之间的手术参数和并发症发生率。PubMed,EMBASE,系统搜索了WebofScience和Scopus数据库。研究中的任何一个感兴趣的主要结果，即，手术时间,伤口感染率，据报道,粘膜穿孔率符合纳入标准.使用随机效应模型进行统计分析。使用纽卡斯尔-渥太华量表评估研究的方法学质量。15项研究包括2964名婴儿。与UMB组相比，RUQ组显示出显著较低的平均手术时间(p=0.0004),伤口感染率（p<0.0001）和粘膜穿孔率（p=0.02）。尽管UMB切口会产生几乎无法察觉的疤痕，这种方法导致明显更多的并发症.因此,在决定IHPS患者的手术方式时,必须权衡风险和收益,并与护理人员进行讨论.然而,由于15项研究中有9项的方法学质量较差，需要进行进一步的研究，以在两组之间进行最佳比较。
