Current understanding of the treatment of newborns with intestinal malrotation: a systematic review

This review aimed to analyze and organize information on the treatment of newborns with bowel malrotation. A systematic review was conducted using the databases PubMed, Web of Science, Google Scholar, Scopus, and eLibrary and journals of Pediatric Surgery, Russian Bulletin of Pediatric Surgery, Anesthesiology and Reanimatology, and Pediatric Surgery from 2010 to 2020. The search terms were as follows: malrotation, neonatal, infant, newborn, intestinal malrotation, malrotation, neonatal period, Ledd’s syndrome, and midgut volvulus. All journal issues were reviewed for the selected period.

Following the screening of published articles, six full-text articles that met the selection criteria were included in the systematic review. A total of 191 patients with bowel malrotation that received various treatments were described: 98 patients underwent defect correction by laparoscopy and 93 patients underwent laparotomy. Bloating was found in 103 children. Reoperations were performed on 18 newborns because of relapse. Complications in the postoperative period were noted in 25 cases, and treatment of 16 children was fatal. No study was performed following a high methodological level.

To date, studies on the surgical treatment of newborns with bowel malrotations are limited. In addition, none of the studies were conducted at a high methodological level. The lack of randomized controlled trials can be compensated for by closer collaboration between medical clinics, collection of a larger evidence base based on the analysis of the results of cohort and case–control studies, and examination of the reasons for the variability of results among centers.