Laparoscopic Repair of Malrotation: What Are the Indications in Neonates and Children?

被引：27
作者：
Miyano, Go [1 ]
Fukuzawa, Hiroaki [1 ]
Morita, Keiichi [1 ]
Kaneshiro, Masakatsu [1 ]
Miyake, Hiromu [1 ]
Nouso, Hiroshi [1 ]
Yamoto, Masaya [1 ]
Fukumoto, Koji [1 ]
Urushihara, Naoto [1 ]
机构：
[1] Shizuoka Childrens Hosp, Dept Pediat Surg, Shizuoka 4208660, Japan
来源：
JOURNAL OF LAPAROENDOSCOPIC & ADVANCED SURGICAL TECHNIQUES | 2015年 / 25卷 / 02期
关键词：
INTESTINAL MALROTATION; SURGICAL-MANAGEMENT; LADD PROCEDURE; VOLVULUS; INFANTS; MIDGUT;
D O I：
10.1089/lap.2014.0236
中图分类号：
R61 [外科手术学];
学科分类号：
摘要：
Aim: To define the role of laparoscopy for treating malrotation in children. Materials and Methods: The Ladd procedure (9 laparoscopic [lap-Ladd], 17 open [open-Ladd]; n=26) was performed in children up to and including 30 days of age (neonatal [Group N]) and older (Group C). These groups were compared retrospectively. Results: Group N (n=14) comprised 3 lap-Ladd and 11 open-Ladd patients. Group C (n=12) comprised 6 lap-Ladd and 6 open-Ladd patients. No case had ischemic bowel preoperatively. Intestinal volvulus was confirmed in 3 of 3 lap-Ladd and 9 of 11 open-Ladd patients in Group N, compared with 5 of 6 lap-Ladd and 6 of 6 open-Ladd patients in Group C (P=not significant). Mean operating times were significantly longer for lap-Ladd patients (130.7 minutes versus 81.1 minutes in Group N and 119.2 minutes versus 74.2 minutes in Group C). Conversion to an open-Ladd procedure was necessary in 1 of 3 patients in Group N and 1 of 6 patients in Group C (P=not significant). Complications arose in open-Ladd patients, bowel obstruction in Group N (1 of 11), and mesenteric chylorrhea in Group C (1 of 6). There was recurrence in 1 of 3 lap-Ladd patients in Group N. Mean time to recommence feeding was earlier for lap-Ladd patients (P=not significant). Length of hospitalization was similar in Group N but was shorter for lap-Ladd patients in Group C (P=not significant). Conclusions: Although lap-Ladd appears to be a safe procedure, it cannot be recommended for the treatment of malrotation in neonates.
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页码：155 / 158
页数：4
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