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Duodenal Atresia: Open versus MIS Repair—Analysis of Our Experience over the Last 12 Years

Authors :
Salvatore Fabio Chiarenza
Lorenzo Costa
Elisa Zolpi
Cosimo Bleve
Lorella Fasoli
Valeria Bucci
Maria Luisa Conighi
Source :
BioMed Research International, BioMed Research International, Vol 2017 (2017)
Publication Year :
2017
Publisher :
Hindawi, 2017.

Abstract

Objective. Duodenal atresia (DA) routinely has been corrected by laparotomy and duodenoduodenostomy with excellent long-term results. We revisited the patients with DA treated in the last 12 years (2004–2016) comparing the open and the minimally invasive surgical (MIS) approach.Methods. We divided our cohort of patients into two groups. Group 1 included 10 patients with CDO (2004–09) treated with open procedure: 5, DA; 3, duodenal web; 2, extrinsic obstruction. Three presented with Down’s syndrome while 3 presented with concomitant malformations. Group 2 included 8 patients (2009–16): 1, web; 5, DA; 2, extrinsic obstruction. Seven were treated by MIS; 1 was treated by Endoscopy. Three presented with Down’s syndrome; 3 presented with concomitant malformations.Results. Average operating time was 120 minutes in Group 1 and 190 minutes in Group 2. In MIS Group the visualization was excellent. We recorded no intraoperative complications, conversions, or anastomotic leakage. Feedings started on 3–7 postoperative days. Follow-up showed no evidence of stricture or obstruction. In Group 1 feedings started within 10–22 days and we have 1 postoperative obstruction.Conclusions. Laparoscopic repair of DA is one of the most challenging procedures among pediatric laparoscopic procedures. These patients had a shorter length of hospitalization and more rapid advancement to full feeding compared to patients undergoing the open approach. Laparoscopic repair of DA could be the preferred technique, safe, and efficacious, in the hands of experienced surgeons.

Details

Language :
English
ISSN :
23146133
Database :
OpenAIRE
Journal :
BioMed Research International
Accession number :
edsair.doi.dedup.....0ccfefb3fa4a5d052f5b5006bda75390
Full Text :
https://doi.org/10.1155/2017/4585360