Open versus laparoscopic approach for intestinal malrotation in infants and children: a systematic review and meta-analysis.


PURPOSE:Although the principles of the Ladd's procedure for intestinal malrotation in children have remained unchanged since its first description, in the era of minimally invasive surgery it is controversial whether laparoscopy is advantageous over open surgery. The aim of our study was to determine whether the surgical approach for the treatment of malrotation had an impact on patient outcome. METHODS:Using a defined strategy (PubMed, Cochrane, Embase and Web of Science MeSH headings), two investigators independently searched for studies comparing open versus laparoscopic Ladd's procedure in children. Case reports and opinion articles were excluded. Outcome measures included age at operation, time to full enteral feeding, length of hospital stay, and post-operative complications. Maneuvers were compared using Fisher's exact test and meta-analysis was conducted using RevMan 5.3. Data are expressed as mean ± SD. RESULTS:Of 308 abstracts screened, 49 full-text articles were analyzed and nine (all retrospective) met our search criteria. Selected articles included 1003 patients, of whom 744 (74 %) underwent open surgery and 259 (26 %) laparoscopy. Patients who had open surgery were younger (0.9 ± 1.2 years) than those who underwent laparoscopy (2.6 ± 3 years; p < 0.0001). Laparoscopy was converted to open Ladd's in 25.3 % patients. Laparoscopy was associated with faster full enteral feeding (1.5 ± 0.3 days) in comparison to open surgery (4.6 ± 0.1 days, p < 0.0001). Length of hospital stay was shorter in the laparoscopic group (5.9 ± 4.3 days) than in the open group (11.2 ± 6.7 days; p < 0.0001). Open surgery was associated with higher overall post-operative complication rate (21 %) than laparoscopy (8 %; p < 0.0001). Although there was no difference in the prevalence of post-operative bowel obstruction (open, n = 10 %; laparoscopy, n = 0 % p = 0.07), post-operative volvulus was more frequent in the laparoscopy group (3.5 %) than in the open group (1.4 %, p = 0.04). CONCLUSION:Comparative but non-randomized studies indicate that laparoscopic Ladd's procedure is not commonly performed in young children. Although one third of laparoscopic procedures is converted to open surgery, laparoscopy is associated with shorter time to full enteral feeds and length of hospital stay. However, laparoscopic Ladd's procedure seems to have higher incidence of post-operative volvulus. Prospective randomized studies with long follow-up are needed to confirm present outcome data and determine the safety and effectiveness of the laparoscopic approach.


Pediatr Surg Int


Catania VD,Lauriti G,Pierro A,Zani A




Has Abstract


2016-12-01 00:00:00














  • Intrathyroidal parathyroid carcinoma in a pediatric patient.

    abstract::Parathyroid carcinoma is unusual and its intrathyroidal variant is extremely rare. Therefore, few cases have been reported to describe a case of parathyroid carcinoma located inside the thyroid gland. The case corresponds to a 14-year-old girl who came to the office with a severe osteoarticular disease, depression, ca...

    journal_title:Pediatric surgery international

    pub_type: 杂志文章


    authors: Herrera-Hernández AA,Aranda-Valderrama P,Díaz-Pérez JA,Herrera LP

    更新日期:2011-12-01 00:00:00

  • Ectopic intrathoracic liver.

    abstract::Accessory hepatic tissue, unlike accessory splenic and pancreatic tissue, is rare and has a limited and almost exclusively sub diaphragmatic distribution. Fewer than ten cases of intrathoracic ectopic liver have been reported so far in the literature. This paper reports a case that caused a diagnostic dilemma. ...

    journal_title:Pediatric surgery international

    pub_type: 杂志文章,评审


    authors: Babu R,Van der Avoirt A

    更新日期:2001-07-01 00:00:00

  • Pediatric living donor liver transplantation for biliary atresia with hepatopulmonary syndrome: the gift of a second wind.

    abstract:PURPOSE:Hepatopulmonary syndrome (HPS) is a progressive, deteriorating complication of end-stage liver disease (ESLD) that occurs in 13-47% of liver transplant candidates. Although LT is the only therapeutic option for HPS, it has a high morbidity and mortality, especially in patients with severe hypoxemia before trans...

    journal_title:Pediatric surgery international

    pub_type: 杂志文章


    authors: Urahashi T,Mizuta K,Sanada Y,Umehara M,Wakiya T,Hishikawa S,Hyodo M,Sakuma Y,Fujiwara T,Yasuda Y,Kawarasaki H

    更新日期:2011-08-01 00:00:00

  • Renal and peri-renal abscesses in children: proposed physio-pathologic mechanisms and treatment algorithm.

    abstract::Renal and perinephric abscess in children are uncommon. Three basic pathophysiologic mechanisms are involved, namely, hematogenous spread, ascending infection and contamination by proximity to an infected area. Six pediatric patients diagnosed with renal abscess were treated at our institution from 1990-2000. Five pat...

    journal_title:Pediatric surgery international

    pub_type: 杂志文章


    authors: Angel C,Shu T,Green J,Orihuela E,Rodriquez G,Hendrick E

    更新日期:2003-04-01 00:00:00

  • Oesophageal atresia is correctable and survivable in infants less than 1 kg.

    abstract:INTRODUCTION:Management of oesophageal atresia (OA) and trachea-oesophageal fistula (TOF) in babies of low birth weight is challenging especially when associated with other anomalies. Birth weight of <1500 g has previously formed part of a classification system designed to predict outcome, alongside the cardiac status ...

    journal_title:Pediatric surgery international

    pub_type: 杂志文章


    authors: Hannon EJ,Billington J,Kiely EM,Pierro A,Spitz L,Cross K,Curry JI,De Coppi P

    更新日期:2016-06-01 00:00:00

  • The use of mesenchymal stem cells in bladder augmentation.

    abstract:PURPOSE:To compare integration of bladder acellular matrix (BAM) with the bladder when seeded with mesenchymal stem cells (MSC) and when MSC are injected intravenously (IV). METHODS:MSCs were isolated from bone marrow of EPM-1 Wistar male rats. Female rats were distributed into: Group A-BAM augmentation; Group B-BAM a...

    journal_title:Pediatric surgery international

    pub_type: 杂志文章


    authors: Leite MT,Freitas-Filho LG,Oliveira AS,Semedo-Kuriki P,Laks M,Arias VE,Peixoto PS

    更新日期:2014-04-01 00:00:00

  • Management of colonic atresia with primary resection and anastomosis.

    abstract:PURPOSE:Historically, the majority of patients with colonic atresia have been managed by ostomy creation at the time of initial operation; conversely, we have tended to treat the atresia with resection and anastomosis. The purpose of this study is to determine the rate of concomitant Hirschsprung's disease and to ident...

    journal_title:Pediatric surgery international

    pub_type: 杂志文章


    authors: Dassinger M,Jackson R,Smith S

    更新日期:2009-07-01 00:00:00

  • Factors responsible for successful primary closure in bladder exstrophy.

    abstract::To assess the important factors for successful primary closure in staged reconstruction of bladder exstrophy, 25 patients (18 males, 7 females) underwent primary bladder closure during the years 1993-1997. Twenty-one were more than 72 h old; all of these underwent bilateral posterior iliac osteotomies followed by prim...

    journal_title:Pediatric surgery international

    pub_type: 杂志文章


    authors: Kasat LS,Borwankar SS

    更新日期:2000-01-01 00:00:00

  • Utility of PAS and β-catenin staining in histological categorisation and prediction of prognosis of hepatoblastomas.

    abstract:AIMS:The aim of this study was to assess the usefulness of PAS, β-catenin and Ki-67 in categorising hepatoblastomas (HBs) and their significance in predicting prognosis. In addition, we have also documented the various chemotherapy induced histologic changes in HBs. METHOD:In this retrospective observational study of ...

    journal_title:Pediatric surgery international

    pub_type: 杂志文章


    authors: Bera G,Das RN,Roy P,Ghosh R,Islam N,Mishra PK,Chatterjee U

    更新日期:2017-09-01 00:00:00

  • Retrocaval ureter in children: a report of two cases.

    abstract::Retrocaval ureter is a relatively rare anomaly that usually manifests in the third or fourth decades. Symptoms are due to ureteric obstruction, either extrinsic by the abnormal inferior vena cava (IVC), or intrinsic ureteric hypoplasia. Surgery is needed for symptomatic cases and involves transection and relocation of...

    journal_title:Pediatric surgery international

    pub_type: 杂志文章


    authors: Soundappan SV,Barker AP

    更新日期:2004-02-01 00:00:00

  • Results of pectus excavatum correction using a minimally invasive approach with subxyphoid incision and three-point fixation.

    abstract:OBJECTIVES:This study reviews the results of our previously described modification of the minimally invasive (Nuss) procedure for correction of pectus excavatum. It utilizes a subxyphoid incision with central fixation to maximize safe bar passage and minimize bar displacement. METHODS:Consecutive patients corrected wi...

    journal_title:Pediatric surgery international

    pub_type: 杂志文章


    authors: Bond SJ,Rapstine E,Bond JM

    更新日期:2018-01-01 00:00:00

  • NKCC-1 and ENaC are down-regulated in nitrofen-induced hypoplastic lungs with congenital diaphragmatic hernia.

    abstract::Congenital diaphragmatic hernia (CDH) is accompanied by pulmonary hypoplasia and pulmonary hypertension. Fetal lung growth is dependent on the secretion of lung liquid, which normally is absorbed at partus. The ion channel NKCC-1 is involved in this secretory process, but has recently also been reported to be implicat...

    journal_title:Pediatric surgery international

    pub_type: 杂志文章


    authors: Ringman A,Zelenina M,Eklöf AC,Aperia A,Frenckner B

    更新日期:2008-09-01 00:00:00

  • Gram-negative organisms in peritoneal dialysis peritonitis: an early indication for surgery in patients with haemolytic uraemic syndrome?

    abstract:PURPOSE:Haemolytic uraemic syndrome (HUS) is the commonest childhood cause of acute renal failure. Peritoneal dialysis peritonitis (PDP) is a well-recognised complication, with some children requiring surgical intervention (SI). The aim of this study is to determine whether the presence of enteric organisms in cases of...

    journal_title:Pediatric surgery international

    pub_type: 杂志文章


    authors: Harwood R,Wilkinson D,Ramkumar S,Humphrey G

    更新日期:2016-03-01 00:00:00

  • Reliability of sonoelastography in predicting pediatric cervical lymph node malignancy.

    abstract:PURPOSE:Controversy exists as regards the best non-invasive diagnostic tool for pediatric cervical lymphadenopathy. The current work aimed to evaluate the reliability, sensitivity, specificity, and accuracy of sonoelastography in diagnosing benign and/or malignant pediatric cervical lymphadenopathy. METHODS:Prospectiv...

    journal_title:Pediatric surgery international

    pub_type: 杂志文章


    authors: Zakaria OM,Mousa A,AlSadhan R,Sultan TA,Eid AF,Daoud MY,Al-Taher A,Zakaria HM,Swaroop K,El-Gibaly AM,Al-Arfaj H,Abdelbary EM

    更新日期:2018-08-01 00:00:00

  • Regional block via continuous caudal infusion as sole anesthetic for inguinal hernia repair in conscious neonates.

    abstract:PURPOSE:The use of general anesthesia in young children has come under increasing scrutiny due to its potential long-term neurotoxic effects. Meanwhile, regional anesthesia for surgical procedures in neonates has many advantages, including preservation of respiratory status and faster return to feeding. We describe the...

    journal_title:Pediatric surgery international

    pub_type: 杂志文章


    authors: Mueller CM,Sinclair TJ,Stevens M,Esquivel M,Gordon N

    更新日期:2017-03-01 00:00:00

  • Laparoscopic surgery for acute neonatal appendicitis.

    abstract::We present the first two cases of acute neonatal appendicitis operated on through the laparoscopic approach. Acute neonatal appendicitis is uncommon and rarely considered by clinicians when assessing the neonatal acute abdomen. Our two cases demonstrate the potential value of diagnostic laparoscopy in the acute neonat...

    journal_title:Pediatric surgery international

    pub_type: 杂志文章


    authors: Malakounides G,John M,Rex D,Mulhall J,Nandi B,Mukhtar Z

    更新日期:2011-11-01 00:00:00

  • Predictors of mortality in pediatric trauma: experiences of a level 1 trauma center and an assessment of the International Classification Injury Severity Score (ICISS).

    abstract:OBJECTIVES:Injury severity scoring tools allow systematic comparison of outcomes in trauma research and quality improvement by indexing an expected mortality risk for certain injuries. This study investigated the predictive value of the empirically derived ICD9-derived Injury Severity Score (ICISS) compared to expert c...

    journal_title:Pediatric surgery international

    pub_type: 杂志文章


    authors: Allen CJ,Wagenaar AE,Horkan DB,Baldor DJ,Hannay WM,Tashiro J,Namias N,Sola JE

    更新日期:2016-07-01 00:00:00

  • Poor catch-up growth after proctocolectomy in pediatric patients with ulcerative colitis receiving prolonged steroid therapy.

    abstract:PURPOSE:The aim of the present study was to review the complications and growth after proctocolectomy and ileal J-pouch anal anastomosis (IPAA) in pediatric ulcerative colitis (UC) patients receiving prolonged steroid therapy. PATIENTS AND METHODS:We experienced 209 patients with UC who received IPAA between September...

    journal_title:Pediatric surgery international

    pub_type: 杂志文章


    authors: Uchida K,Araki T,Inoue M,Otake K,Yoshiyama S,Koike Y,Matsushita K,Okita Y,Miki C,Kusunoki M

    更新日期:2010-04-01 00:00:00

  • Choledochal cyst and duodenal atresia: a rare combination.

    abstract::A rare case of congenital duodenal atresia (DA) associated with a choledochal cyst (CC) is reported. At 38 weeks of gestation, a 1,610-g girl was born by cesarean section with a prenatal diagnosis of DA. After the disorder was confirmed by X-ray, she underwent a duodenoduodenostomy for a complete separation of the duo...

    journal_title:Pediatric surgery international

    pub_type: 杂志文章


    authors: Sugimoto T,Yamagiwa I,Obata K,Ouchi T,Takahashi R,Suzuki R,Shimazaki Y

    更新日期:2002-05-01 00:00:00

  • Surgical jejunostomy and radiological gastro-jejunostomy tube feeding in children: risks, benefits and nutritional outcomes.

    abstract:PURPOSE:Radiologically inserted gastrojejunal tubes (RGJ) and surgical jejunostomy (SJ) are established modes of jejunal feeding. The aim of the study is to review nutritional outcomes, complications and the practical consideration to enable patients and carers to make informed choice. METHODS:Retrospective review of ...

    journal_title:Pediatric surgery international

    pub_type: 杂志文章


    authors: Singh RR,Eaton S,Roebuck DJ,Barnacle AM,Chippington S,Cross KMK,De Coppi P,Curry JI

    更新日期:2018-09-01 00:00:00

  • Postoperative complications in adults with anorectal malformation: a need for transition. German Network for Congenital Uro-REctal Malformations (CURE-Net).

    abstract:PURPOSE:The aim of the German Network for Congenital Uro-REctal malformations (CURE-Net) is to collect data of affected patients with anorectal malformation (ARM) to investigate molecular causes, clinical implications and psychosocial outcome. The current issue was to examine the transition to adulthood in adults with ...

    journal_title:Pediatric surgery international

    pub_type: 杂志文章


    authors: Schmidt D,Jenetzky E,Zwink N,Schmiedeke E,Maerzheuser S

    更新日期:2012-08-01 00:00:00

  • Feasibility of perineal sagittal approaches in patients without anorectal malformations.

    abstract::Perineal sagittal approaches (posterior sagittal anorectoplasty and anterior and posterior sagittal transanorectal approaches) allow complete anatomic exposure of the perineum and lower pelvis. Moreover, they reduce the risk of damaging important structures because the incision is led in the midline. Therefore, many s...

    journal_title:Pediatric surgery international

    pub_type: 杂志文章


    authors: Pini Prato A,Martucciello G,Torre M,Jasonni V

    更新日期:2004-10-01 00:00:00

  • Concealed penis.

    abstract::A small phallus causes great concern regarding genital adequacy. A concealed penis, although of normal size, appears small either because it is buried in prepubic tissues, enclosed in scrotal tissue penis palmatus (PP), or trapped due to phimosis or a scar following circumcision or trauma. From July 1978 to January 20...

    journal_title:Pediatric surgery international

    pub_type: 杂志文章


    authors: Radhakrishnan J,Razzaq A,Manickam K

    更新日期:2002-12-01 00:00:00

  • Role of laparoscopy in treatment of choledochal cysts in children.

    abstract::Laparoscopy enables surgeons to approach the surgical conditions from a new perspective. Laparoscopic surgery has revolutionized the treatment of choledochal cysts (CDC). Yet, this new technique requires objective evaluations. We have examined the controversies about the CDC dissection, distal common bile duct ligatio...

    journal_title:Pediatric surgery international

    pub_type: 杂志文章,评审


    authors: Diao M,Li L,Cheng W

    更新日期:2013-04-01 00:00:00

  • Beta haemolytic streptococcal infection does not cause right diaphragmatic eventration

    abstract::Numerous case reports in the literature have suggested a causal link between beta-haemolytic streptococcal infection and delayed-onset right-sided diaphragmatic hernia/eventration in the perinatal age group. We report a child with antenatally documented right diaphragmatic eventration 4 weeks before birth who subseque...

    journal_title:Pediatric surgery international

    pub_type: 杂志文章


    authors: Jain M,Ford WDA,Hayward C

    更新日期:1997-03-21 00:00:00

  • Posterior urethral valves after infancy-urodynamic consequences.

    abstract::This study describes a subset of patients with posterior urethral valves (PUV) who presented late in childhood. The objective was to identify factors that lead to back-pressure effects on the upper tracts, which persist in spite of adequate valve ablation in some patients, and seek factors that may preserve the upper ...

    journal_title:Pediatric surgery international

    pub_type: 杂志文章


    authors: Krishna A,Lal P,Gupta A,Madan U

    更新日期:1998-09-01 00:00:00

  • Post-chemotherapy microscopic residual prostate rhabdomyosarcoma: long-term conservative follow-up.

    abstract::In spite of advances in the treatment of childhood bladder and prostate rhabdomyosarcoma (RMS), the ability to detect minimal residual disease correlates imperfectly with the ultimate outcome. We report the long-term follow-up of a child with microscopic residual RMS after chemotherapy. The correct interpretation of t...

    journal_title:Pediatric surgery international

    pub_type: 杂志文章


    authors: Chertin B,Reinus C,Koulikov D,Rosenmann E,Farkas A,Chertin B

    更新日期:2002-01-01 00:00:00

  • Elective laparoscopic gastrostomy in children: potential for an enhanced recovery protocol.

    abstract:PURPOSE:Gastrostomy tube placement is one of the most commonly performed pediatric surgical procedures and discharge is possible as early as the first postoperative day with early initiation of feeds postoperatively. We examined a national database to determine hospital length of stay (LOS) after elective laparoscopic ...

    journal_title:Pediatric surgery international

    pub_type: 杂志文章


    authors: Williams K,Baumann L,Abdullah F,Hendrickson RJ,Oyetunji TA

    更新日期:2019-06-01 00:00:00

  • Home intravenous versus oral antibiotics following appendectomy for perforated appendicitis in children: a randomized controlled trial.

    abstract:PURPOSE:To compare the effect of home intravenous (IV) versus oral antibiotic therapy on complication rates and resource utilization following appendectomy for perforated appendicitis. METHODS:This was a randomized controlled trial of patients aged 4-17 with surgically treated perforated appendicitis from January 2011...

    journal_title:Pediatric surgery international

    pub_type: 杂志文章,随机对照试验


    authors: Arnold MR,Wormer BA,Kao AM,Klima DA,Colavita PD,Cosper GH,Heniford BT,Schulman AM

    更新日期:2018-12-01 00:00:00

  • Ultrasound-guided percutaneous sclerotherapy of hydatid liver cysts in children.

    abstract::To evaluate the efficacy of ultrasound (US) guided percutaneous sclerotherapy in the pediatric population, 14 hydatid liver cysts (HLC) in eight male patients whose ages ranged between 6 and 16 years (mean 9.9 years) were treated. The maximum diameter was 110 mm. Albendazole was administered orally to all patients for...

    journal_title:Pediatric surgery international

    pub_type: 杂志文章


    authors: Kabaalioğlu A,Karaali K,Apaydin A,Melikoğlu M,Sindel T,Lüleci E

    更新日期:2000-01-01 00:00:00