Comparative evaluation of endosurgical and open intervention in newborns with duodenal obstruction
- Authors: Mokrushina O.G.1,2, Razumovskiy A.Y.1,2, Shumikhin V.S.1,2, Levitskaya M.V.2, Nagornaya J.V.1,2, Smirnova S.V.1,2, Halafov R.V.1,2, Petrova L.V.2, Koshko O.V.2, Emirbekova S.K.2
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Affiliations:
- Pirogov Russian National Medical University
- Filatov Children’s Hospital
- Issue: Vol 12, No 1 (2022)
- Pages: 9-18
- Section: Original Study Articles
- URL: https://journals.rcsi.science/2219-4061/article/view/123539
- DOI: https://doi.org/10.17816/psaic1002
- ID: 123539
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Abstract
BACKGROUND: Duodenal atresia is one of the most common malformations of the intestine in newborns. Both open surgical interventions and the laparoscopic method eliminate duodenal obstruction.
AIM: This study conducts a comparative analysis of the results of treating newborns by these methods.
MATERIALS AND METHODS: This paper summarizes the experience of treating 185 newborns operated in the clinic for duodenal obstruction. Two groups of patients are presented: the first included 110 children operated on laparoscopically, the second included 75 patients operated on by the open method. Both groups are comparable regarding newborn anthropometric data, age at the time of surgery, and the presence of concomitant anomalies. The study considered indicators characterizing the surgical intervention and the course of the postoperative period.
RESULTS: In a series of studies, there were no differences between groups in interpreting the cause of obstruction (p = 0.184) and the presence of an incomplete turn (p = 0.134). Operating time in the laparoscopy group was higher than in the laparotomy group (75 min and 70 min, p < 0.001). However, the reduced duration of mechanical ventilation, earlier initiation of feeding, transition to complete enteral nutrition and reduced length of hospital stay suggest the benefits of laparoscopy over laparotomy for treating congenital duodenal obstruction (p < 0.001). The frequency of postoperative complications is not high in both groups (p = 0.634). The analysis results showed that laparoscopy does not complicate the intraoperative interpretation of organ relationships, provides a more favorable course during the postoperative period, and does not increase the number of postoperative complications.
CONCLUSION: The laparoscopic method improves medical efficiency in treating newborns with duodenal obstruction than open surgery.
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##article.viewOnOriginalSite##About the authors
Olga G. Mokrushina
Pirogov Russian National Medical University; Filatov Children’s Hospital
Email: mokrusina@yandex.ru
ORCID iD: 0000-0003-4444-6103
SPIN-code: 5998-7470
Dr. Sci. (Med.), MD
Russian Federation, 15, Sadovaya-Kudrinskaya st., Moscow, 103001; MoscowAlexandr Yu. Razumovskiy
Pirogov Russian National Medical University; Filatov Children’s Hospital
Email: 1595105@mail.ru
ORCID iD: 0000-0002-9497-4070
SPIN-code: 3600-4701
Dr. Sci. (Med.), Professor, Corresponding Member of RAS
Russian Federation, 15, Sadovaya-Kudrinskaya st., Moscow, 103001; MoscowVasiliy S. Shumikhin
Pirogov Russian National Medical University; Filatov Children’s Hospital
Email: pennylane@yandex.ru
ORCID iD: 0000-0001-9477-8785
SPIN-code: 6405-8928
Cand. Sci. (Med.)
Russian Federation, 15, Sadovaya-Kudrinskaya st., Moscow, 103001; MoscowMarina V. Levitskaya
Filatov Children’s Hospital
Email: urolog@neosurg.ru
ORCID iD: 0000-0002-9838-9493
SPIN-code: 2609-2557
Cand. Sci. (Med.), pediatric surgery
Russian Federation, 15, Sadovaya-Kudrinskaya st., Moscow, 103001Juliya V. Nagornaya
Pirogov Russian National Medical University; Filatov Children’s Hospital
Email: jov@list.ru
ORCID iD: 0000-0002-1702-7811
SPIN-code: 2262-3990
Cand. Sci. (Med.), MD, Pediatric Surgery
Russian Federation, 15, Sadovaya-Kudrinskaya st., Moscow, 103001; MoscowSvetlana V. Smirnova
Pirogov Russian National Medical University; Filatov Children’s Hospital
Email: swsmirnowa@gmail.com
ORCID iD: 0000-0001-9158-4571
SPIN-code: 8996-7065
Cand. Sci. (Med.), MD, Pediatric Surgery
Russian Federation, 15, Sadovaya-Kudrinskaya st., Moscow, 103001; MoscowRashid V. Halafov
Pirogov Russian National Medical University; Filatov Children’s Hospital
Email: drrash777@gmail.com
ORCID iD: 0000-0001-7998-5639
SPIN-code: 7141-9649
Cand. Sci. (Med.), MD, Pediatric Surgery
Russian Federation, 15, Sadovaya-Kudrinskaya st., Moscow, 103001; MoscowLubov V. Petrova
Filatov Children’s Hospital
Email: celine1988@mail.ru
ORCID iD: 0000-0001-8727-5514
SPIN-code: 8928-4543
pediatric surgery
Russian Federation, 15, Sadovaya-Kudrinskaya st., Moscow, 103001Olga V. Koshko
Filatov Children’s Hospital
Email: kas321@gmail.com
ORCID iD: 0000-0002-6946-938X
SPIN-code: 5870-3630
Anesthesiologist
Russian Federation, 15, Sadovaya-Kudrinskaya st., Moscow, 103001Svetlana K. Emirbekova
Filatov Children’s Hospital
Author for correspondence.
Email: aisha.shabanova@yandex.ru
ORCID iD: 0000-0003-0334-3255
SPIN-code: 5936-6025
Anesthesiologist
Russian Federation, 15, Sadovaya-Kudrinskaya st., Moscow, 103001References
- Kimura K, Tsugawa C, Ogawa K, et al. Diamond-shaped anastomosis for congenital duodenal obstruction. Arch Surg. 1977;112(10):1262–1263. doi: 10.1155/2009/175963
- Bax NM, Ure BM, van der Zee DC, et al. Laparoscopic duodenoduodenostomy for duodenal atresia. Surg Endosc. 2001;15(2):217. doi: 10.1007/s004640042009
- Rothenberg SS. Laparoscopic duodenoduodenostomy for duodenal obstruction in infants and children. J Pediatr Surg. 2002;37(7):1088–1089. doi: 10.1053/jpsu.2002.33882
- Chung PH, Wong CW, Ip DK, et al. Is laparoscopic surgery better than open surgery for the repair of congenital duodenal obstruction? A review of the current evidence. J Pediatr Surg. 2017;52(3):498–503. doi: 10.1016/j.jpedsurg.2016.08.010
- Kozlov YuA, Novozhilov VA, Tysyachnyy AS, et al. Comparison of the laparotomy and laparoscopy in treatment of duodenal atresia. Russian Journal of Surgery. 2013;(4):26–34. (In Russ.).
- Spilde TL, St Peter SD, Keckler SJ, et al. Open vs laparoscopic repair of congenital duodenal obstructions: a concurrent series. J Pediatr Surg. 2008;43(6):1002–1005. doi: 10.1016/j.jpedsurg.2008.02.021
- Parmentier B, Peycelon M, Muller CO, et al. Laparoscopic management of congenital duodenal atresia or stenosis: a single-center early experience. J Pediatr Surg. 2015;50(11):1833–1836. doi: 10.1016/j.jpedsurg.2015.05.007
- Van der Zee DC. Laparoscopic repair of duodenal atresia: revisited. World J Surg. 2011;35(8):1781–1784. doi: 10.1007/s00268-011-1147-y
- Riquelme M, Aranda A, Riquelme-Q M, Rodriquez C. Laparoscopic treatment of duodenal obstruction: report on first experiences in Latin America. Eur J Pediatr Surg. 2008;18(5):334–336. doi: 10.1055/s-2008-1038532
- Son TN, Liem NT, Kien HH. Laparoscopic simple oblique duodenoduodenostomy in management of congenital duodenal obstruction in children. J Laparoendosc Adv Surg Tech A. 2015;25(2):163–166. doi: 10.1016/j.jpedsurg.2017.08.064
- Jensen AR, Short SS, Anselmo DM, et al. Laparoscopic versus open treatment of congenital duodenal obstruction: multicenter short-term outcomes analysis. J Laparoendosc Adv Surg Tech A. 2013;23(10):876–880. doi: 10.1089/lap.2013.0140
- Hill S, Koontz CS, Langness SM, Wulkan ML. Laparoscopic versus open repair of congenital duodenal obstruction in infants. J Laparoendosc Adv Surg Tech A. 2011;21(10):961–963. doi: 10.1089/lap.2011.0069
- Chiarenza SF, Bucci V, Conighi ML, et al. Duodenal atresia: open versus MIS repair-analysis of our experience over the last 12 years. Biomed Res Int. 2017:4585360. doi: 10.1155/2017/4585360
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