Transition from Laparotomy to Laparoscopic Repair of Congenital Duodenal Obstruction in Neonates: Our Early Experience
BackgroundThe aim of this report was to review our early experience of the last 7 years with repairs of congenital duodenal obstruction (CDO) to determine the efficacy and outcomes of laparoscopic repairs compared to laparotomy.MethodsA retrospective review was conducted on all neonate (<30 d...
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doaj-3014cba7386d43b4bfa6651a18597e992020-11-24T23:14:49ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602017-09-01510.3389/fped.2017.00203297391Transition from Laparotomy to Laparoscopic Repair of Congenital Duodenal Obstruction in Neonates: Our Early ExperienceMin Jeng Cho0Dae Yeon Kim1Seong Chul Kim2Jung Man Namgoong3Department of Surgery, Ulsan University Hospital, Ulsan, South KoreaDivision of Pediatric Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South KoreaDivision of Pediatric Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South KoreaDivision of Pediatric Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South KoreaBackgroundThe aim of this report was to review our early experience of the last 7 years with repairs of congenital duodenal obstruction (CDO) to determine the efficacy and outcomes of laparoscopic repairs compared to laparotomy.MethodsA retrospective review was conducted on all neonate (<30 days) with CDO between 2009 and 2015. Patients with duodenal atresia, stenosis, web, and annular pancreas were included. Patients with only malrotation or delayed presentation were excluded.ResultsTwenty-six neonates underwent laparoscopy and 30 underwent traditional laparotomy. The operative time was longer in the laparoscopic group (P = 0.001), but time to initiation of feeds and time to full feeds were similar for the laparoscopic and open groups. There was no mortality, anastomosis leakage, or stenosis in the laparoscopic group. Six laparoscopic cases required conversion to an open procedure (23%). In the earlier cases, the open conversion rate was high, but it decreased over time (P = 0.003).ConclusionLaparoscopic repair is safe and effective for repair of CDO in neonates. Despite operative time was slightly longer in the laparoscopic group, clinical outcomes remained similar to the open group. For pediatric surgeon with experience in laparoscopic techniques, laparoscopic duodenoduodenostomy is a sufficient available procedure.http://journal.frontiersin.org/article/10.3389/fped.2017.00203/fullduodenal obstructionduodenoduodenostomylaparoscopyneonatelaparotomy |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Min Jeng Cho Dae Yeon Kim Seong Chul Kim Jung Man Namgoong |
spellingShingle |
Min Jeng Cho Dae Yeon Kim Seong Chul Kim Jung Man Namgoong Transition from Laparotomy to Laparoscopic Repair of Congenital Duodenal Obstruction in Neonates: Our Early Experience Frontiers in Pediatrics duodenal obstruction duodenoduodenostomy laparoscopy neonate laparotomy |
author_facet |
Min Jeng Cho Dae Yeon Kim Seong Chul Kim Jung Man Namgoong |
author_sort |
Min Jeng Cho |
title |
Transition from Laparotomy to Laparoscopic Repair of Congenital Duodenal Obstruction in Neonates: Our Early Experience |
title_short |
Transition from Laparotomy to Laparoscopic Repair of Congenital Duodenal Obstruction in Neonates: Our Early Experience |
title_full |
Transition from Laparotomy to Laparoscopic Repair of Congenital Duodenal Obstruction in Neonates: Our Early Experience |
title_fullStr |
Transition from Laparotomy to Laparoscopic Repair of Congenital Duodenal Obstruction in Neonates: Our Early Experience |
title_full_unstemmed |
Transition from Laparotomy to Laparoscopic Repair of Congenital Duodenal Obstruction in Neonates: Our Early Experience |
title_sort |
transition from laparotomy to laparoscopic repair of congenital duodenal obstruction in neonates: our early experience |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Pediatrics |
issn |
2296-2360 |
publishDate |
2017-09-01 |
description |
BackgroundThe aim of this report was to review our early experience of the last 7 years with repairs of congenital duodenal obstruction (CDO) to determine the efficacy and outcomes of laparoscopic repairs compared to laparotomy.MethodsA retrospective review was conducted on all neonate (<30 days) with CDO between 2009 and 2015. Patients with duodenal atresia, stenosis, web, and annular pancreas were included. Patients with only malrotation or delayed presentation were excluded.ResultsTwenty-six neonates underwent laparoscopy and 30 underwent traditional laparotomy. The operative time was longer in the laparoscopic group (P = 0.001), but time to initiation of feeds and time to full feeds were similar for the laparoscopic and open groups. There was no mortality, anastomosis leakage, or stenosis in the laparoscopic group. Six laparoscopic cases required conversion to an open procedure (23%). In the earlier cases, the open conversion rate was high, but it decreased over time (P = 0.003).ConclusionLaparoscopic repair is safe and effective for repair of CDO in neonates. Despite operative time was slightly longer in the laparoscopic group, clinical outcomes remained similar to the open group. For pediatric surgeon with experience in laparoscopic techniques, laparoscopic duodenoduodenostomy is a sufficient available procedure. |
topic |
duodenal obstruction duodenoduodenostomy laparoscopy neonate laparotomy |
url |
http://journal.frontiersin.org/article/10.3389/fped.2017.00203/full |
work_keys_str_mv |
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