Perioperative parameter analysis of neonates and infants receiving laparoscopic surgery

The field of laparoscopic surgery in neonates or younger infants has benefitted from recent progress. This study aimed to determine the correlation between patient characteristics and perioperative parameters, and to explore the feasibility of laparoscopic surgery in neonates and infants.

We retrospectively collected and analyzed data on neonates and infants who received laparoscopic surgery at our institute between January 2007 and August 2015. Perioperative data, surgical outcomes, and related complications were analyzed using Spearman rank correlation coefficient.

A total of 82 patients (42 male and 40 female) were included in this study. The median operative age and the median operative body weight were 2.2 months and 4.2 kg, respectively. The median operative time was 3.5 hours, and the median insufflation time was 2.0 hours. The mean intraoperative end-tidal carbon dioxide (EtCO2) level was 37.6 mmHg, the median body temperature (BT) was 35.8°C, and the mean peak inspiratory pressure was 23.3 cmH2O. The median follow-up duration was 23.4 months. The intraoperative BT was significantly influenced by the operative age (p < 0.001, rs = 0.52) and body weight (p < 0.001, rs = 0.59). The intraoperative EtCO2 level was higher for longer operative time (p = 0.01, rs = 0.28) and insufflation time (p < 0.001, rs = 0.39); however, all values returned to normal when the CO2 insufflation was stopped.

Laparoscopic surgery for neonates and infants can be safely performed by experienced surgeons. However, transient hypercarbia may rapidly ameliorate after CO2 insufflation is stopped.