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01-08-2011 | Original Article

Laparoscopic approach for children with inflammatory bowel diseases

Authors: Girolamo Mattioli, Alessio Pini-Prato, Arrigo Barabino, Paolo Gandullia, Stefano Avanzini, Edoardo Guida, Valentina Rossi, Luca Pio, Nicola Disma, Leila Mameli, Della Rocca Mirta, Giovanni Montobbio, Vincenzo Jasonni

Published in: Pediatric Surgery International | Issue 8/2011

Abstract

Background

Minimally invasive surgery is being increasingly applied to inflammatory bowel diseases (IBDs). Few pediatric series from selected research have been described to date. This study describes a unicentric experience of laparoscopic treatment of children with IBDs.

Materials and methods

All consecutive patients with IBDs between February 2006 and February 2010 who underwent laparoscopic treatment were included. We reviewed notes and recorded demographic data, indications, perioperative management, surgical details, length of surgery, complications, postoperative management, length of hospitalization and functional outcome.

Results

We performed 25 procedures on 16 patients (12 ulcerative colitis, 3 Crohn’s disease, and 1 indeterminate colitis). Median age was 12 years. A total of 50% patients underwent elective surgery; 11 underwent staged laparoscopic subtotal colectomy (LSTC) followed by J-pouch ileorectal anastomosis (JPIRA). Three patients underwent straight LSTC + JPIRA. All procedures included protective ileostomy. Length of surgery ranged between 120 and 380 min depending on the procedure (LSTC ± JPIRA). No conversion was required. Length of hospitalization ranged between 3 and 18 days. We observed six complications (24%) mainly represented by adhesions that were effectively treated laparoscopically. Ten patients were restored (ileostomy closure) and were assessed for continence that turned out to be good in 80%.

Conclusions

Laparoscopy proved to be feasible, safe and effective for the treatment of IBD in children. Although we observed a relatively low incidence of complications, stoma site adhesions still remain the major issue, which can be effectively dealt with laparoscopically. Functional outcome as well as cosmesis is satisfactory. As results are encouraging, at present we prefer laparoscopy for the surgical treatment of IBD in pediatric patients.

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Title: Laparoscopic approach for children with inflammatory bowel diseases
Authors: Girolamo Mattioli
Alessio Pini-Prato
Arrigo Barabino
Paolo Gandullia
Stefano Avanzini
Edoardo Guida
Valentina Rossi
Luca Pio
Nicola Disma
Leila Mameli
Della Rocca Mirta
Giovanni Montobbio
Vincenzo Jasonni
Publication date: 01-08-2011
Publisher: Springer-Verlag
Published in: Pediatric Surgery International / Issue 8/2011
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-011-2885-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Laparoscopic approach for children with inflammatory bowel diseases

Abstract

Background

Materials and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Materials and methods

Results

Conclusions

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