Laparoscopic repair of malrotation: What are the indications in neonates and children?

Go Miyano, Hiroaki Fukuzawa, Keiichi Morita, Masakatsu Kaneshiro, Hiromu Miyake, Hiroshi Nouso, Masaya Yamoto, Koji Fukumoto, Naoto Urushihara

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Abstract

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.

Original languageEnglish
Pages (from-to)155-158
Number of pages4
JournalJournal of Laparoendoscopic and Advanced Surgical Techniques
Volume25
Issue number2
DOIs
Publication statusPublished - Feb 1 2015
Externally publishedYes

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ASJC Scopus subject areas

  • Surgery

Cite this

Miyano, G., Fukuzawa, H., Morita, K., Kaneshiro, M., Miyake, H., Nouso, H., Yamoto, M., Fukumoto, K., & Urushihara, N. (2015). Laparoscopic repair of malrotation: What are the indications in neonates and children? Journal of Laparoendoscopic and Advanced Surgical Techniques, 25(2), 155-158. https://doi.org/10.1089/lap.2014.0236