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Published on: August 11, 2023
[Endoscopic treatment of intestinal malrotation in newborns and infants]
Yu A Kozlov1, V A Novozhilov2, A A Rasputin3
1City Ivano-Matreninskaya Children's Clinical Hospital, Irkutsk; Irkutsk State Medical Academy of Postgraduate Education, Irkutsk.
Insights
Laparoscopic surgery for intestinal malrotation in infants offers faster nutrition, shorter hospital stays, and comparable complication rates compared to open surgery. This minimally invasive approach provides better postoperative outcomes for pediatric patients.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Gastrointestinal Surgery
Background:
- Intestinal malrotation is a congenital anomaly requiring surgical correction.
- Laparoscopy and laparotomy are established surgical approaches for Ladd's procedure.
- Comparing outcomes between laparoscopic and open surgery is crucial for pediatric care.
Purpose of the Study:
- To compare the efficacy and outcomes of laparoscopic versus open Ladd's procedure for intestinal malrotation in infants.
- To evaluate postoperative recovery parameters, including nutrition, hospital stay, and complications.
Main Methods:
- A retrospective study of 34 infants undergoing Ladd's procedure between 2004 and 2013.
- Patients were divided into two groups: 17 laparoscopic (Group I) and 17 open laparotomy (Group II).
- Demographic, operative, and postoperative data were analyzed.
Main Results:
- Laparoscopic surgery showed a shorter operative time (61 vs. 70 minutes) and earlier initiation of nutrition (1.5 vs. 3 days).
- Full enteral nutrition was achieved faster (4.2 vs. 6.9 days) and hospital stay was shorter (7.7 vs. 10.2 days) with laparoscopy.
- Early postoperative complications were similar; remote complications were slightly higher but not statistically significant in the laparotomy group.
Conclusions:
- Laparoscopic correction of intestinal malrotation yields superior postoperative results compared to open surgery.
- Minimally invasive surgery is a safe and effective option for treating congenital anomalies of intestinal rotation in young children.
- Endoscopic correction is recommended for widespread use in pediatric patients.
Aim:
To compare treatment of intestinal malrotation in newborns and infants using laparoscopy and laparotomy.
Material And Methods:
For the period from January 2004 to December 2013 34 Ladd's procedures were performed. Children were divided into 2 groups by 17 patients: laparoscopic (group I) and open treatment (group II).
Results:
Both groups had similar demographic and other preoperative parameters. There were significant differences in duration of operation between both groups (61 vs. 70 minutes). Nutrition was initiated earlier after mini-invasive treatment (1.5 days vs. 3 days) and the time need for full enteral nutrition was also less (4.2 days vs. 6.9 days). Hospital-stay was shorter in group I (7.7 vs. 10.2 days). Number of early postoperative complications was similar in groups. Incidence of remote complications was higher in laparotomy group but the differences were not significant.
Conclusion:
Our results showed that endoscopic correction of congenital anomalies of intestinal rotation provides better postoperative results than open surgery and can be widely used in young children.
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