Abstract
PURPOSE: The purpose of this study is to discuss indications, technical approach, and morbidity of laparoscopic approaches to major bowel resection in the pediatric/adolescent population with inflammatory bowel disease and familial polyposis. METHODS: Retrospective review of laparoscopic-assisted bowel procedures between May 1991 and January 2002 was performed. Laparoscopic-assisted bowel resection is defined as complete intracorporeal mobilization and devascularization of a segment of colon or rectum. The indications for extracorporeal vs. intracorporeal anastomosis will be discussed. Clinically unstable, septic, or massively bleeding patients were not candidates for this technique. The decision to attempt the laparoscopic approach was based on the experience of the consulting surgeon. There were 31 patients, including 14 females. Five patients had undergone prior surgery. Twenty-nine patients had inflammatory bowel disease, one had familial polyposis, and one had a cavernous hemangioma. We included all pediatric/adolescent patients in our practice undergoing laparoscopic resection. RESULTS: Twenty-nine patients had 33 laparoscopic operations, including proctocolectomy with ileal pouch-anal anastomosis (n = 14), proctocolectomy with ileostomy (n = 3), ileocolectomy with ileocolic anastomosis (n = 13), and small-bowel obstruction (n = 1). Average operating time was 158 (range, 30–400) minutes, with average blood loss of 159 ml. Average wound length was 4.9 cm. The complication rate was 16 percent (n = 5), with one anastomotic leak. The rate of conversion to open operations was 5.8 percent. Liquid diet was begun on Day 3, and the average length of stay was 5.9 days. CONCLUSION: Major laparoscopic bowel surgery can be performed safely in the pediatric/adolescent population, with reasonable operative times, low conversion to open operations, and low morbidity.
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References
SL Gans G Berci (1973) ArticleTitleAdvances in endoscopy of infants and children J Pediatr Surg 8 399–409
SL Gans (1977) ArticleTitleA new look at pediatric endoscopy Postgrad Med 61 91–100
SL Gans G Berci (1971) ArticleTitlePeritoneoscopy in infants and children J Pediatr Surg 6 199–233
BF Gilchrist TE Lobe DP Schropp et al. (1992) ArticleTitleIs there a role for laparoscopic appendectomy in pediatric surgery? J Pediatr Surg 27 209–214
JL Alain D Grousseau G Terrier (1991) ArticleTitleExtramucosal pyloromyotomy by laparoscopy J Pediatr Surg 26 1191–1192
JM Garbutt NJ Soper WD Shannon A Botero B Littenberg (1999) ArticleTitleMeta-analysis of randomized controlled trials comparing laparoscopic and open appendectomy Surg Laparosc Endosc 9 17–26
M Hashizume M Ohta F Kishihara et al. (1996) ArticleTitleLaparoscopic splenectomy for idiopathic thrombocytopenic purpura Surg Laparosc Endosc 6 129–135
DA Rogers TE Lobe KP Schropp (1992) ArticleTitleEvolving uses of laparoscopy in children Surg Clin North Am 72 1299–1313
CM Scmidt MA Talamini HS Kaufman KD Lilliemoe P Learn T Bayless (2001) ArticleTitleLaparoscopic surgery for Crohn’s disease Ann Surg 233 733–739
WA Bemelman JF Slors MS Dunker et al. (2000) ArticleTitleLaparoscopic-assisted vs. open ileocolic resection for Crohn’s disease Surg Endosc 14 721–725
O Alabaz AJ Iroatulam A Nessim et al. (2000) ArticleTitleComparison of laparoscopically assisted and conventional ileocolic resection for Crohn’s disease Eur J Surg 166 213–217
KA Ludwig JW Milson JM Church VW Fazio (1996) ArticleTitlePreliminary experience with laparoscopic intestinal surgery for Crohn’s disease Am J Surg 171 52–56
KD Newman LM Marmon R Attori S Evans (1991) ArticleTitleLaparoscopic cholecystectomy in pediatric patients J Pediatr Surg 26 1184–1185
HH Sigman JM Laberge D Croitoru A Hong D Sigman FM Guttman (1991) ArticleTitleLaparoscopic cholecystectomy J Pediatr Surg 26 1181–1183
GW Holcomb SuffixIII DO Olsen KW Sharp (1991) ArticleTitleLaparoscopic cholecystectomy in the pediatric patient J Pediatr Surg 26 1186–1190
MS Dunker WA Bemelman JF Slors P van Duijvendijk DJ Gouma (2001) ArticleTitleFunctional outcome, quality of life, body image, and cosmesis in patients after laparoscopic-assisted and conventional restorative proctocolectomy Dis Colon Rectum 44 1800–1807
SR Brown KW Eu F Seow-Choen (2001) ArticleTitleConsecutive series of laparoscopic-assisted vs. minilaparotomy restorative proctocolectomies Dis Colon Rectum 44 397–400
GC Hoffman JW Baker CW Fitchett JH Vansant (1994) ArticleTitleLaparoscopic assisted colectomy Ann Surg 219 732–743
BD Schirmer (1996) ArticleTitleLaparoscopic colon resection Surg Clin North Am 76 571–583
SW Larach SK Patankar A Ferrara PR Williamson SE Perozo AS Lord (1997) ArticleTitleComplications of laparoscopic colorectal surgery Dis Colon Rectum 40 592–596
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Simon, T., Orangio, G., Ambroze, W. et al. Laparoscopic-Assisted Bowel Resection in Pediatric/Adolescent Inflammatory Bowel Disease. Dis Colon Rectum 46, 1325–1331 (2003). https://doi.org/10.1007/s10350-004-6742-7
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DOI: https://doi.org/10.1007/s10350-004-6742-7