Single surgeon experience with laparoscopic surgery in pediatric patients with inflammatory bowel disease

Renee Huang, Issam Koleilat, Edward C. Lee

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Purpose: Laparoscopic management of inflammatory bowel disease (IBD) has been well established in adults. Its efficacy and safety are less defined in pediatrics. We reviewed our single surgeon laparoscopic experience with pediatric IBD patients. Patients and Methods: All consecutive patients 17 years old or younger with IBD who underwent initial laparoscopic surgery for management of disease from May 2002 to May 2011 were identified. Patients were analyzed retrospectively with respect to age, gender, weight, American Society of Anesthesiologists classification, history of prior abdominal surgery, operative time, need for conversion to open procedure, estimated blood loss, need for blood transfusion, length of hospitalization, need for intensive care unit monitoring, and patient outcomes within 30 days. Results: In total, 44 pediatric patients underwent 52 laparoscopic surgeries. Forty-two patient cases (80.8%) had had no prior abdominal surgery. Mean operative time was 132 minutes. Two patients (3.8%) underwent conversion from a laparoscopic to open approach. Mean estimated blood loss was 64 mL. The average hospitalization was 5.5 days. Postoperative complications occurred in 10 patients (19.2%): 2 were treated for wound infection or abscess, 7 required re-admission, and 1 required return to the operating room for exploratory laparotomy. Conclusions: Laparoscopic management of IBD has not routinely been implemented in the pediatric population. We demonstrate acceptable perioperative morbidity and rate of conversion to open with an overall successful laparoscopic approach in pediatric patients. This may have particular long-term benefits in a population faced with longer life expectancy. An initial laparoscopic approach is a feasible and safe option for pediatric IBD patients.

Original languageEnglish (US)
Pages (from-to)61-64
Number of pages4
JournalJournal of Laparoendoscopic and Advanced Surgical Techniques
Volume23
Issue number1
DOIs
StatePublished - Jan 1 2013
Externally publishedYes

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Inflammatory Bowel Diseases
Laparoscopy
Pediatrics
Operative Time
Hospitalization
Surgeons
Conversion to Open Surgery
Physiologic Monitoring
Wound Infection
Operating Rooms
Disease Management
Life Expectancy
Blood Transfusion
Laparotomy
Abscess
Population
Intensive Care Units
Morbidity
Safety
Weights and Measures

ASJC Scopus subject areas

  • Surgery

Cite this

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title = "Single surgeon experience with laparoscopic surgery in pediatric patients with inflammatory bowel disease",
abstract = "Purpose: Laparoscopic management of inflammatory bowel disease (IBD) has been well established in adults. Its efficacy and safety are less defined in pediatrics. We reviewed our single surgeon laparoscopic experience with pediatric IBD patients. Patients and Methods: All consecutive patients 17 years old or younger with IBD who underwent initial laparoscopic surgery for management of disease from May 2002 to May 2011 were identified. Patients were analyzed retrospectively with respect to age, gender, weight, American Society of Anesthesiologists classification, history of prior abdominal surgery, operative time, need for conversion to open procedure, estimated blood loss, need for blood transfusion, length of hospitalization, need for intensive care unit monitoring, and patient outcomes within 30 days. Results: In total, 44 pediatric patients underwent 52 laparoscopic surgeries. Forty-two patient cases (80.8{\%}) had had no prior abdominal surgery. Mean operative time was 132 minutes. Two patients (3.8{\%}) underwent conversion from a laparoscopic to open approach. Mean estimated blood loss was 64 mL. The average hospitalization was 5.5 days. Postoperative complications occurred in 10 patients (19.2{\%}): 2 were treated for wound infection or abscess, 7 required re-admission, and 1 required return to the operating room for exploratory laparotomy. Conclusions: Laparoscopic management of IBD has not routinely been implemented in the pediatric population. We demonstrate acceptable perioperative morbidity and rate of conversion to open with an overall successful laparoscopic approach in pediatric patients. This may have particular long-term benefits in a population faced with longer life expectancy. An initial laparoscopic approach is a feasible and safe option for pediatric IBD patients.",
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AU - Huang, Renee

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AU - Lee, Edward C.

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N2 - Purpose: Laparoscopic management of inflammatory bowel disease (IBD) has been well established in adults. Its efficacy and safety are less defined in pediatrics. We reviewed our single surgeon laparoscopic experience with pediatric IBD patients. Patients and Methods: All consecutive patients 17 years old or younger with IBD who underwent initial laparoscopic surgery for management of disease from May 2002 to May 2011 were identified. Patients were analyzed retrospectively with respect to age, gender, weight, American Society of Anesthesiologists classification, history of prior abdominal surgery, operative time, need for conversion to open procedure, estimated blood loss, need for blood transfusion, length of hospitalization, need for intensive care unit monitoring, and patient outcomes within 30 days. Results: In total, 44 pediatric patients underwent 52 laparoscopic surgeries. Forty-two patient cases (80.8%) had had no prior abdominal surgery. Mean operative time was 132 minutes. Two patients (3.8%) underwent conversion from a laparoscopic to open approach. Mean estimated blood loss was 64 mL. The average hospitalization was 5.5 days. Postoperative complications occurred in 10 patients (19.2%): 2 were treated for wound infection or abscess, 7 required re-admission, and 1 required return to the operating room for exploratory laparotomy. Conclusions: Laparoscopic management of IBD has not routinely been implemented in the pediatric population. We demonstrate acceptable perioperative morbidity and rate of conversion to open with an overall successful laparoscopic approach in pediatric patients. This may have particular long-term benefits in a population faced with longer life expectancy. An initial laparoscopic approach is a feasible and safe option for pediatric IBD patients.

AB - Purpose: Laparoscopic management of inflammatory bowel disease (IBD) has been well established in adults. Its efficacy and safety are less defined in pediatrics. We reviewed our single surgeon laparoscopic experience with pediatric IBD patients. Patients and Methods: All consecutive patients 17 years old or younger with IBD who underwent initial laparoscopic surgery for management of disease from May 2002 to May 2011 were identified. Patients were analyzed retrospectively with respect to age, gender, weight, American Society of Anesthesiologists classification, history of prior abdominal surgery, operative time, need for conversion to open procedure, estimated blood loss, need for blood transfusion, length of hospitalization, need for intensive care unit monitoring, and patient outcomes within 30 days. Results: In total, 44 pediatric patients underwent 52 laparoscopic surgeries. Forty-two patient cases (80.8%) had had no prior abdominal surgery. Mean operative time was 132 minutes. Two patients (3.8%) underwent conversion from a laparoscopic to open approach. Mean estimated blood loss was 64 mL. The average hospitalization was 5.5 days. Postoperative complications occurred in 10 patients (19.2%): 2 were treated for wound infection or abscess, 7 required re-admission, and 1 required return to the operating room for exploratory laparotomy. Conclusions: Laparoscopic management of IBD has not routinely been implemented in the pediatric population. We demonstrate acceptable perioperative morbidity and rate of conversion to open with an overall successful laparoscopic approach in pediatric patients. This may have particular long-term benefits in a population faced with longer life expectancy. An initial laparoscopic approach is a feasible and safe option for pediatric IBD patients.

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