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Clinical Characteristics and Treatment of Gastric Duplications in Children
Meiyan Wang1, Linyan Wang2, Yi Chen2
1Chun'an First People's Hospital, Hangzhou, China.
Insights
Gastric duplication (GD) in children is rare and often asymptomatic when diagnosed prenatally. Robot-assisted surgery offers effective treatment with reduced blood loss and shorter hospital stays compared to other laparoscopic methods.
Area of Science:
- Pediatric Surgery
- Congenital Malformations
- Gastrointestinal Disorders
Background:
- Gastric duplication (GD) is a rare congenital gastrointestinal malformation typically identified in childhood.
- Clinical characteristics and treatment of GD in pediatric patients remain areas for investigation.
Purpose of the Study:
- To investigate the clinical characteristics of gastric duplication in children.
- To evaluate and compare different surgical treatment modalities for pediatric GD.
Main Methods:
- Retrospective comparative study of 38 pediatric patients diagnosed with GD between August 2013 and December 2023.
- Surgical interventions included laparoscopy converted to open procedures (LOG), complete laparoscopic procedures (LG), and robot-assisted procedures (RG).
Main Results:
- Prenatally diagnosed GD cases were treated significantly earlier and had fewer symptoms than postnatally diagnosed cases.
- Robot-assisted procedures (RG) showed the lowest intraoperative blood loss and shortest postoperative hospital stay compared to LOG and LG.
- While RG had higher hospitalization costs, it demonstrated good therapeutic effects with a low conversion rate to open procedures.
Conclusions:
- Gastric duplication in children is rare with non-specific clinical signs, emphasizing the importance of prenatal diagnosis.
- Early diagnosis and treatment, particularly with robot-assisted procedures, can lead to favorable outcomes in pediatric GD management.
Background:
Gastric duplication (GD) is a rare congenital gastrointestinal malformation, and usually identified in childhood. This study aimed to investigate the clinical characteristics and treatment of GDs in children.
Methods:
A retrospective review was conducted of medical records of 38 patients with the diagnosis of GD, treated in the Department of General Surgery, Children's Hospital of Zhejiang University School of Medicine, within the period from August 2013 to December 2023. Patients treated with laparoscopic conversion to open procedures, complete laparoscopic procedures, or robot-assisted procedures.
Results:
There were 23 males and 15 females. All cases were cystic, and all but one had no communication with gastric lumen. Ten cases (26.3 %) were symptomatic, 18 (47.4 %) were detected prenatally and 10 (26.3 %) were detected by examination. Patients diagnosed prenatally were treated much earlier (1.1 (0.2-1.6) years VS 6.4 (2.2-9.8) years; P < 0.001) and have a much lower incidence of symptoms (0 VS 50 %; P < 0.001) than those diagnosed postnatal. Twenty-one patients underwent laparoscopic exploration, which consist of the laparoscopy converted to open procedures group (LOG, n = 9), and complete laparoscopic procedures group (LG, n = 12). Robot-assisted procedures group (RG) including 17 patients. There was no significant difference in patients' age, weight, operation time, the postoperative fasting duration and postoperative complications between the three groups (P > 0.05). The estimated intraoperative blood loss was the highest in LOG (10 (7.5-10) ml), followed by LG (4 (2-5) ml), and RG (2 (1-2) ml) was the lowest. The postoperative hospital stay was shorter in the RG (6 (6-8)) than in the LOG (11 (7.5-12.5)), and there was no significant difference between the other two groups. The RG had a significantly higher hospitalization cost (P < 0.05) than other two groups.
Conclusions:
Gastric duplication in children is rare, and has no specific clinical manifestations. Most cases were diagnosed prenatally and can be diagnosed and treated early after birth. Robot-assisted procedure can achieve good therapeutic effects, with less blood loss and low conversion rate to open procedure.
Type Of Study:
Retrospective Comparative Study.
Level Of Evidence:
Level III.
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