Bogota Bag Temporary Abdominal Closure Surgical Technique in Children: A 15-Year Single Center Experience
Eitan Neeman1,2, Nitza Heiman Newman3,2, Yuval Cavari1,2
1Pediatric Intensive Care Unit, Soroka University Medical Center, Beer Sheva, Israel.
Insights
The Bogota bag (BB) technique offers a simple, inexpensive method for temporary abdominal closure in pediatric patients. This study highlights its application and outcomes in 17 children over 15 years.
Area of Science:
- Surgical Techniques
- Pediatric Surgery
- Critical Care Medicine
Background:
- Temporary abdominal closure (TAC) is used when the abdominal wall cannot be closed post-surgery.
- The Bogota bag (BB) is a tension-free TAC method using a sterilized fluid bag.
- Limited data exists on BB use in pediatric populations.
Purpose of the Study:
- To report 15 years of institutional experience with the BB technique in pediatric patients.
- To evaluate the safety and efficacy of BB in children.
- To contribute to the limited literature on pediatric TAC.
Main Methods:
- Retrospective cohort study of 17 pediatric patients (0-18 years).
- Review of medical records for patients treated with BB between 2000 and 2014.
- Analysis of indications, duration of BB use, and patient outcomes.
Main Results:
- 17 pediatric patients received BB for indications including re-exploration, inability for primary closure, and high risk of abdominal compartment syndrome (ACS).
- Median BB duration was 5 days; median bag replacement was 2 days.
- 6 patients (35%) died during admission; others had complications unrelated to BB, primarily due to their underlying disease.
Conclusions:
- This study represents the largest series of pediatric patients treated with the Bogota bag technique.
- The BB technique is simple, cost-effective, and associated with minimal complications.
- BB is a viable option for temporary abdominal closure in pediatric surgery.
Background:
Temporary abdominal closure (TAC) surgical technique relates to a procedure in which the post-surgical abdominal wall remains open in certain indications. The Bogota bag (BB) technique is a tension-free TAC method that covers the abdominal contents with a sterilized fluid bag. There are very few reports of pediatric patients treated with this technique.
Objectives:
To describe our institution's 15 years of experience using the BB technique on pediatric patients.
Methods:
A retrospective cohort study describing our experience treating patients with BB was conducted. The medical files of 17 pediatric patients aged 0-18 years were reviewed.
Results:
Between January 2000 and December 2014, 17 patients were treated with BB at our medical center (6 females, median age 12 years). Indications for BB were a need for a surgical site re-exploration, mechanical inability for primary abdominal closure, and high risk for ACS development. Median BB duration was 5 days and median bag replacement was 2 days. Median ICU length of stay (LOS) was 10 days and hospital LOS was 27 days. The ICU admission and BB procedure was tolerated well by 6 patients who were discharged home without complications. Of the remaining 11 patients, 6 patients died during the admission (35%) and the others presented with major complications not related to the BB but to the patient's primary disease.
Conclusions:
This report represents the largest series of children treated with BB. The technique is simple to perform, inexpensive, and has very few complications.
