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Laparoscopic repair versus open laparotomy in congenital duodenal obstruction (Abstract)

JC Gouli¹, H Allal¹, F Paniagua², G Andrianandraina¹, N Kalfa¹, RB Galifer¹

¹Pediatric Visceral Surgery Department, Lapeyronie Hospital, CHU Montpellier, France

²Pediatric Visceral Department, Hospital Niño Poblano, Puebla, México

 

Abstract

Background: Congenital duodenal obstruction (CDO) is one of the most common anomalies in newborns. Laparoscopic approach nowadays is performed for CDO treatment. We present our result comparing laparoscopic repair (LR) versus open laparotomy (OL).  

Patients and methods: We have done a retrospective analysis on records of all newborns admit-ted to our center from January 2000 to December 2008 with diagnosis of CDO, dividing them into 2 groups according to the operative approach. Operative time, hospitalization length, baby’s weight at entry and at discharge, time of initial and full oral feeding were analyzed statistically according to Student t test. The remaining data were listed as descriptive statistic.

Results: Twenty patients were enrolled. Age ranged from 1 to 17 days (three boys and 17 girls). Six babies (30%) were born prematurely (31 through 36 weeks gestation). Group 1 (LR) = 8 patients and group 2 (OL) =12 patients.  The mean weight at surgery was: group 1= 2897.5g and group 2 2369.1g. Twelve patients (60%) had associated anomalies. The mean of the operative time was longer in group 1 (136.5 versus 99 minutes). The length of hospitalization was similar between two groups (15.3 vs. 16.8 days). Time of initial feeding (4.5 vs. 7.36 days) was statistically different. Two patients in group 2 presented obstruction due to intestinal adhesions after 2.5 and 4 years.  

Conclusions:  Length of hospital stay is similar in both approaches; feeding was earlier using LR. The cosmetic advantage and prevention of intestinal adhesions encourage the use of laparoscopy.

 

Keys words: congenital duodenal obstruction, laparoscopic repair, newborn

 

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