Laparoscopy-Assisted Versus Open Surgery in Treating Intestinal Atresia: Single Center Experience.

Autor: Lima M; Pediatric Surgery Department, S. Orsola Hospital/University of Bologna, Bologna, Italy., Di Salvo N; Pediatric Surgery Department, S. Orsola Hospital/University of Bologna, Bologna, Italy., Cordola C; Pediatric Surgery Department, S. Orsola Hospital/University of Bologna, Bologna, Italy., D'Antonio S; Pediatric Surgery Department, S. Orsola Hospital/University of Bologna, Bologna, Italy., Libri M; Pediatric Surgery Department, S. Orsola Hospital/University of Bologna, Bologna, Italy., Maffi M; Pediatric Surgery Department, S. Orsola Hospital/University of Bologna, Bologna, Italy., Gargano T; Pediatric Surgery Department, S. Orsola Hospital/University of Bologna, Bologna, Italy., Ruggeri G; Pediatric Surgery Department, S. Orsola Hospital/University of Bologna, Bologna, Italy., Catania VD; Pediatric Surgery Department, S. Orsola Hospital/University of Bologna, Bologna, Italy.
Jazyk: angličtina
Zdroj: Journal of investigative surgery : the official journal of the Academy of Surgical Research [J Invest Surg] 2021 Aug; Vol. 34 (8), pp. 842-847. Date of Electronic Publication: 2020 Jan 08.
DOI: 10.1080/08941939.2019.1704316
Abstrakt: Introduction: Surgical management of jejuno-ileal atresia/stenosis (JIA) is shifting to a minimally invasive approach. Our purpose is to evaluate the safety and feasibility of laparoscopy-assisted surgery (LAS) in JIA by comparing outcomes with a control group of open surgery (OS).
Methods: A retrospective review of JIA cases was performed. Demographic, surgical, and outcomes data were extracted. LAS cases were compared with OS. Fisher's exact-test for qualitative and Mann-Whitney-test for quantitative values were used. p values <0.05 were considered significant.
Results: Forty-seven patients (24/23, F/M) were included. In 19 (40%), the LAS technique was successfully performed, while 3 (17%) required conversion to OS. No differences were observed between the LAS and OS ( n  = 28) groups concerning demographic data (sex, mean gestational age, mean weight, associated anomalies) and type of JIA. Operative time was shorter in LAS (112 ± 46 min) compared to OS (138 ± 40 min), p  = 0.04. Time to start enteral feeding and time to full enteral was shorter in LAS compared to OS, p  = 0.04. No difference was observed between the two groups concerning duration of parenteral nutrition, length of hospitalization and weight at discharge. Overall rate of postoperative complications was 14% ( n  = 7), with a slightly prevalence in OS (18%) compared to LAS (10%), p  = 0.68.
Conclusions: The LAS technique in the treatment of neonatal JIA is safe and feasible. LAS is associated with shorter operative and restoration of enteral feeding times. The post-operative outcomes in LAS are similar with OS, with a lower rate of postoperative complications.
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje