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Laparoscopic repair of traumatic bowel injury in children
Christian J Streck1, Thom E Lobe, John B Pietsch
1Department of Pediatric Surgery, University of Tennessee-Memphis Health Science Center, Memphis, TN 38163, USA.
Insights
Laparoscopic repair of isolated intestinal injuries in children with focal abdominal trauma is effective. This minimally invasive approach offers a faster return to function and shorter hospital stays compared to traditional surgery.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Trauma Surgery
Background:
- Focal abdominal trauma in children can lead to isolated intestinal injuries.
- Surgical repair is necessary for these traumatic bowel injuries.
- Laparoscopic techniques are increasingly explored for pediatric surgical conditions.
Purpose of the Study:
- To evaluate the efficacy of laparoscopic repair for isolated intestinal injuries in pediatric patients.
- To compare laparoscopic repair outcomes with traditional laparotomy for traumatic bowel injuries.
- To assess the safety and benefits of minimally invasive surgery in pediatric abdominal trauma.
Main Methods:
- Retrospective review of pediatric patients (≤16 years) with isolated intestinal injuries from focal abdominal trauma.
- Inclusion criteria: hemodynamically stable, preoperative diagnosis of intestinal injury.
- Exclusion criteria: multisystem injuries, gunshot wounds, hemodynamic instability.
Main Results:
- Laparoscopic repair was performed in 8 children with gastrointestinal injuries.
- Laparoscopic-assisted repair/resection was used in 6 additional patients.
- Laparoscopic repair showed favorable outcomes in operating time, diet resumption, and discharge time compared to laparotomy, with no early or late complications.
Conclusions:
- Laparoscopic repair (primary or assisted) is a viable surgical option for hemodynamically stable children with focal abdominal trauma-related bowel injuries.
- This approach may lead to quicker intestinal function recovery and reduced hospital stays.
- Minimally invasive surgery offers a safe and effective alternative for pediatric traumatic bowel injuries.
Purpose:
The aim of this study was to evaluate the laparoscopic repair of isolated intestinal injuries in children who sustain focal abdominal trauma.
Methods:
A retrospective review was conducted of all patients 16 years and younger who required surgery for traumatic bowel injuries during a 5-year period at 2 university children's hospitals. The study population was composed of hemodynamically stable patients who sustained focal energy transfer to the abdomen and were diagnosed preoperatively with intestinal injury. Children sustaining multisystem injuries and gunshot wounds or who were hemodynamically unstable were excluded.
Results:
Fifty hemodynamically stable children were explored for preoperatively documented intestinal injury sustained after focal abdominal trauma. Laparoscopy was used to repair intracorporeally gastrointestinal injuries in 8 children. Mean operating time, time to diet, and time to discharge after laparoscopic bowel repair compared favorably with patients managed by laparotomy. An additional 6 patients had a laparoscopic-assisted bowel resection or repair after exteriorization only of the ruptured intestine through a short extension of the nearest port site. No early (missed injury, wound infection, bleeding) or late (obstruction) complications resulted after laparoscopic repair.
Conclusions:
Laparoscopic primary or assisted repair of injured bowel is an appropriate surgical option in hemodynamically stable children who sustain focal abdominal trauma and may be associated with a more prompt return of intestinal function and shorter hospital stay.
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