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Laparoscopic surgery in children with congenital heart disease
Lauren A Gillory1, Michael L Megison, Carroll M Harmon
1University of Alabama at Birmingham, Birmingham, AL 35233, USA.
Insights
Laparoscopic surgery is safe for children with congenital heart disease. Outcomes were similar to open procedures, with low complications and no mortality in this study.
Area of Science:
- Pediatric Surgery
- Congenital Heart Disease
- Minimally Invasive Surgery
Background:
- Congenital heart disease (CHD) presents unique challenges for pediatric surgical interventions.
- Laparoscopic procedures offer potential benefits like reduced pain and faster recovery in pediatric surgery.
- The safety and efficacy of laparoscopic surgery in infants and young children with CHD require further investigation.
Purpose of the Study:
- To evaluate the outcomes of laparoscopic procedures in children under 5 years old diagnosed with congenital heart disease.
- To compare the safety and effectiveness of laparoscopic versus open abdominal surgery in this specific pediatric population.
Main Methods:
- A retrospective review of 111 children with CHD undergoing 121 laparoscopic procedures over 10 years.
- Comparison of patient demographics, operative details, complications, and 30-day mortality between laparoscopic and open surgery groups.
- Inclusion criteria: children younger than 5 years with CHD.
Main Results:
- No intraoperative hemodynamic instability was observed during laparoscopic procedures.
- Low postoperative complication rates (5%) and zero 30-day mortality in the laparoscopic group.
- No significant differences in operative time, complications, or mortality were found when comparing laparoscopic and open procedures.
Conclusions:
- Laparoscopic surgery is a safe and viable option for children with congenital heart disease.
- No major contraindications were identified for performing laparoscopic procedures in this patient group.
- Laparoscopic surgery demonstrates comparable outcomes to open surgery for pediatric patients with CHD.
Purpose:
The study aim was to determine outcomes of children with congenital heart disease who underwent laparoscopic procedures.
Methods:
A single-institution, institutional review board-approved, retrospective review was conducted including children younger than 5 years with congenital heart disease who underwent laparoscopic or open abdominal procedures. Patient demographics, operative details, complications, and 30-day mortality were examined.
Results:
Over 10 years, 111 children with congenital heart disease underwent 121 laparoscopic procedures. Median age was 2.5 months, with 87% being infants. Laparoscopic gastrostomy was the most common procedure (101). There was no intraoperative hemodynamic instability, median operative time was 70 minutes, postoperative complications were low (5%), and all children were alive at 30 days. Only 8 patients required conversion from laparoscopic to open, all secondary to technical issues, not hemodynamic instability. There were 42 children with cardiac disease who underwent 45 open procedures during the study period. There were no significant differences between patient demographics, type of procedure, operative time, complications, or 30-day mortality comparing the open and laparoscopic groups.
Conclusion:
In this review, there were no major contraindications to performing laparoscopic procedures in children with congenital heart disease, and we conclude that it is reasonably safe to perform laparoscopic surgery on these children.