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Single-incision Laparoscopic Surgery for Neonatal Congenital Duodenal Obstruction: A Retrospective Study of 130
Aohua Song1, Xiao Xiang1, Bobin Zhang1
1Department of Neonatal Surgery, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development, Chongqing Key Laboratory of Structural Birth Defect and Reconstruction, Chongqing, PR China.
Objectives:
This study sought to assess the advantages of utilizing the single-incision laparoscopic surgery (SILS) procedure for repairing neonatal congenital duodenal obstruction (CDO) in terms of clinical outcomes and complication rates.
Methods:
In a retrospective cohort study conducted at a single center, neonates with CDO who underwent SILS were compared to those who underwent conventional laparoscopic surgery (CLS) between January 2018 and December 2022. The demographic and operative characteristics of CDO patients who underwent SILS or CLS were analyzed, including conversion rates and postoperative complications.
Results:
Of these, 75 patients were assigned to the CLS group, while 55 patients belonged to the SILS group. No statistically significant differences were detected between the two groups in terms of baseline characteristics. The median operative time was significantly longer in the SILS group than in the CLS group (130 min vs. 120 min, P = 0.02). The SILS group experienced a longer delay in the initiation of feeds than did the CLS group (5 days vs. 4 days, p = 0.001); however, there was no statistically significant difference in the time to reach full feeds between the two groups (9 days vs. 9 days, p = 0.07). In the SILS group, the incidences of incisional hernia and infection were higher than those in the CLS group, but the differences were not statistically significant (9.09 % vs. 4.00 %, P = 0.41 & 10.91 % vs. 5.33 %, P = 0.39). There were no statistically significant differences in the incidences of anastomotic stricture/leakage, adhesive intestinal obstruction, or missed diagnosis related to malformation between the two groups. The incidence of conversion to laparotomy was found to be 6.67 % and 9.09 % in the respective groups, with no statistically significant difference detected.
Conclusion:
The efficacy and safety of the SILS procedure for neonatal CDO repair are comparable to those of the CLA procedure, and the SILS procedure has potential cosmetic advantages.
