Is there a need for bowel management after surgery for isolated intestinal malrotation in children?
(2019) In Pediatric Gastroenterology, Hepatology and Nutrition 22(5). p.447-452- Abstract
Purpose: Few studies have reported non-acute long-term morbidity rates in children with intestinal malrotation. The aim of this study was to investigate the rate of constipation in children undergoing Ladd's procedure for isolated intestinal malrotation. Methods: This retrospective study included children aged <15 years who underwent Ladd's procedure for intestinal malrotation between 2001 and 2016. Demographics, presence of volvulus perioperatively, need for bowel resection, short term (<30 days) and long-term complications, including mortality were recorded. Constipation was defined as treatment with laxatives at 1-year follow-up. Results: Of the 43 children included in the study, 49% were boys. The median age at surgery was 28... (More)
Purpose: Few studies have reported non-acute long-term morbidity rates in children with intestinal malrotation. The aim of this study was to investigate the rate of constipation in children undergoing Ladd's procedure for isolated intestinal malrotation. Methods: This retrospective study included children aged <15 years who underwent Ladd's procedure for intestinal malrotation between 2001 and 2016. Demographics, presence of volvulus perioperatively, need for bowel resection, short term (<30 days) and long-term complications, including mortality were recorded. Constipation was defined as treatment with laxatives at 1-year follow-up. Results: Of the 43 children included in the study, 49% were boys. The median age at surgery was 28 days (0-5, 293 days). Volvulus occurred in 26 children (60.5%), and bowel resection was required in 4 children (9.3%). Short-term complications categorized as grades II-V according to the Clavien-Dindo classification occurred in 13 children (30.2%). Of these, 5 children (11.6%) required re-operation. Constipation was observed in 9 children (23.7%) at the 1-year follow-up. No difference was observed in the rate of perioperative volvulus between children with and without constipation (44% vs. 65%, p=0.45). Excluding re-operations performed within 30 days after surgery, 3 children (6%) underwent surgery for intestinal obstruction during the study period. Conclusion: Many children undergoing Ladd's procedure require bowel management even at long-term follow-up, probably secondary to constipation. It is important to thoroughly evaluate bowel function at the time of follow-up to verify or exclude constipation, and if treatment of constipation is unsuccessful, these children require evaluation for dysmotility disorders and/or intestinal neuronal dysplasia. Copyright
(Less)
- author
- Salö, Martin LU
- organization
- publishing date
- 2019
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Bowel management, Intestinal malrotation, Outcome
- in
- Pediatric Gastroenterology, Hepatology and Nutrition
- volume
- 22
- issue
- 5
- pages
- 6 pages
- publisher
- Korean Society of Pediartic Gastroenterology, Hepatology and Nutrition
- external identifiers
-
- scopus:85076513429
- pmid:31555569
- ISSN
- 2234-8646
- DOI
- 10.5223/pghn.2019.22.5.447
- language
- English
- LU publication?
- yes
- id
- 040614d6-9b1f-44b0-b65a-bde69debf886
- date added to LUP
- 2020-01-14 13:02:27
- date last changed
- 2024-05-30 09:54:21
@article{040614d6-9b1f-44b0-b65a-bde69debf886,
abstract = {{<p>Purpose: Few studies have reported non-acute long-term morbidity rates in children with intestinal malrotation. The aim of this study was to investigate the rate of constipation in children undergoing Ladd's procedure for isolated intestinal malrotation. Methods: This retrospective study included children aged <15 years who underwent Ladd's procedure for intestinal malrotation between 2001 and 2016. Demographics, presence of volvulus perioperatively, need for bowel resection, short term (<30 days) and long-term complications, including mortality were recorded. Constipation was defined as treatment with laxatives at 1-year follow-up. Results: Of the 43 children included in the study, 49% were boys. The median age at surgery was 28 days (0-5, 293 days). Volvulus occurred in 26 children (60.5%), and bowel resection was required in 4 children (9.3%). Short-term complications categorized as grades II-V according to the Clavien-Dindo classification occurred in 13 children (30.2%). Of these, 5 children (11.6%) required re-operation. Constipation was observed in 9 children (23.7%) at the 1-year follow-up. No difference was observed in the rate of perioperative volvulus between children with and without constipation (44% vs. 65%, p=0.45). Excluding re-operations performed within 30 days after surgery, 3 children (6%) underwent surgery for intestinal obstruction during the study period. Conclusion: Many children undergoing Ladd's procedure require bowel management even at long-term follow-up, probably secondary to constipation. It is important to thoroughly evaluate bowel function at the time of follow-up to verify or exclude constipation, and if treatment of constipation is unsuccessful, these children require evaluation for dysmotility disorders and/or intestinal neuronal dysplasia. Copyright</p>}},
author = {{Salö, Martin}},
issn = {{2234-8646}},
keywords = {{Bowel management; Intestinal malrotation; Outcome}},
language = {{eng}},
number = {{5}},
pages = {{447--452}},
publisher = {{Korean Society of Pediartic Gastroenterology, Hepatology and Nutrition}},
series = {{Pediatric Gastroenterology, Hepatology and Nutrition}},
title = {{Is there a need for bowel management after surgery for isolated intestinal malrotation in children?}},
url = {{http://dx.doi.org/10.5223/pghn.2019.22.5.447}},
doi = {{10.5223/pghn.2019.22.5.447}},
volume = {{22}},
year = {{2019}},
}