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Risk Factors for Intestinal Obstruction After Ladd Procedure
Tetsuya Mitsunaga1, Takeshi Saito1, Keita Terui1
1Department of Pediatric Surgery, Graduate School of Medicine, Chiba University , Japan.
Intestinal obstruction is a frequent complication following the Ladd procedure. Adhesions, not recurrent volvulus, cause obstruction, with intestinal ischemia being a significant risk factor.
Area of Science:
- Pediatric Surgery
- Gastrointestinal Surgery
Background:
- Intestinal obstruction is a known complication after the Ladd procedure.
- The Ladd procedure is commonly performed for conditions like intestinal malrotation.
Purpose of the Study:
- To identify the causes and risk factors for intestinal obstruction after the Ladd procedure.
- To evaluate the incidence of intestinal obstruction in patients who underwent the Ladd procedure.
Main Methods:
- Retrospective review of 93 patients who underwent the Ladd procedure between 1977 and 2013.
- Analysis of cases with and without subsequent intestinal obstruction.
Main Results:
- Intestinal obstruction occurred in 25.3% of patients post-Ladd procedure.
- Obstruction was caused by adhesions, not recurrent volvulus.
- Intestinal ischemia during the initial operation was a significant risk factor (59.1% of obstruction cases).
Conclusions:
- Adhesions are the primary cause of intestinal obstruction after the Ladd procedure.
- Adequate widening of the mesenteric base is crucial.
- Patients experiencing intestinal ischemia during the Ladd procedure have a higher risk of developing intestinal obstruction.
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