Presenter Status
Fellow
Abstract Type
Research
Primary Mentor
Tolulope Oyetunji
Start Date
10-5-2023 12:45 PM
End Date
10-5-2023 1:00 PM
Presentation Type
Oral Presentation-Restricted Access
Description
Background: The use of laparoscopy for duodenal atresia (DA) repair has been increasing. However, there is no consensus regarding which surgical approach has better outcomes.
Objectives/Goal: We aimed to compare the different surgical approaches and types of anastomoses for DA repair.
Methods/Design: Following IRB approval, patients who underwent DA repair at a single center were identified between January 2006-June 2022. Those with concomitant gastrointestinal anomalies or who required other simultaneous operations were excluded. The primary outcome was the rate of complications, defined as rate of leak, stricture, and re-operation by surgical approach and technique of anastomosis. Logistic regression was used to analyze the relationship between weight, surgical approach, surgery time, diagnosis, and complication probability. Significance was defined as a P < 0.05.
Results: A total of 78 patients were included. The majority were female (51.3%, n=40), with a median age of 4 days (IQR 3.0,8.0) and a median weight of 2.7 kg (IQR 2.2,3.3) at repair. Diagnoses included pure DA (61.5%, n=48) and annular pancreas (38.5%, n=30). The predominant surgical approach was laparoscopic (L) (64.1%, n=50), followed by open (O) (23.1%, n=18), laparoscopic-assisted (LA) (10.3%, n=8), and laparoscopic converted to open (LCO) (2.6%, n=2). Most anastomoses were handsewn (HS) (62.8%, n=49), followed by Uclip (UC) (28.2%, n=22), and stapled (S) (9.0%, n=7). The re-operation rate was 7.7% (n=6), of which two were anastomotic leaks, and four were anastomotic strictures. The leak rate was 5.6% (n=1/18) for the O-HS and 4.8% (n=1/21) for the L-HS technique. The stricture rate was 12.5% (n=1/8) for the LA-HS, 9.1% (n=2/22) for the L-UC, 4.8% (n=1/21) for the L-HS, and none with L-S and LCO-HS techniques. No differences were found in logistic regression when controlling for any variables.
Conclusions: The method of surgical approach did not affect the outcomes or complications in the repair of duodenal atresia.
MeSH Keywords
duodenal atresia; outcomes research; laparoscopy
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Duodenal Atresia Repair: A Single-Center Comparative Study
Background: The use of laparoscopy for duodenal atresia (DA) repair has been increasing. However, there is no consensus regarding which surgical approach has better outcomes.
Objectives/Goal: We aimed to compare the different surgical approaches and types of anastomoses for DA repair.
Methods/Design: Following IRB approval, patients who underwent DA repair at a single center were identified between January 2006-June 2022. Those with concomitant gastrointestinal anomalies or who required other simultaneous operations were excluded. The primary outcome was the rate of complications, defined as rate of leak, stricture, and re-operation by surgical approach and technique of anastomosis. Logistic regression was used to analyze the relationship between weight, surgical approach, surgery time, diagnosis, and complication probability. Significance was defined as a P < 0.05.
Results: A total of 78 patients were included. The majority were female (51.3%, n=40), with a median age of 4 days (IQR 3.0,8.0) and a median weight of 2.7 kg (IQR 2.2,3.3) at repair. Diagnoses included pure DA (61.5%, n=48) and annular pancreas (38.5%, n=30). The predominant surgical approach was laparoscopic (L) (64.1%, n=50), followed by open (O) (23.1%, n=18), laparoscopic-assisted (LA) (10.3%, n=8), and laparoscopic converted to open (LCO) (2.6%, n=2). Most anastomoses were handsewn (HS) (62.8%, n=49), followed by Uclip (UC) (28.2%, n=22), and stapled (S) (9.0%, n=7). The re-operation rate was 7.7% (n=6), of which two were anastomotic leaks, and four were anastomotic strictures. The leak rate was 5.6% (n=1/18) for the O-HS and 4.8% (n=1/21) for the L-HS technique. The stricture rate was 12.5% (n=1/8) for the LA-HS, 9.1% (n=2/22) for the L-UC, 4.8% (n=1/21) for the L-HS, and none with L-S and LCO-HS techniques. No differences were found in logistic regression when controlling for any variables.
Conclusions: The method of surgical approach did not affect the outcomes or complications in the repair of duodenal atresia.
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