Purpose The difficulty of performing laparoscopic surgery in small infants rem ains a common complaint of pediatric surgeons. The aim of this study was to eval uate the complications of laparoscopic surgery in small i...Purpose The difficulty of performing laparoscopic surgery in small infants rem ains a common complaint of pediatric surgeons. The aim of this study was to eval uate the complications of laparoscopic surgery in small infants weighing less th an 5 kg. Methods Since 1997, 154 infants weighing less than 5 kg underwent lapar oscopic surgery (group S). During that same period, 96 infants weighing less tha n 10 kg (group M)-and 335 children weighing more than 10 kg (group L) also unde rwent laparoscopic surgery. Intra-and postoperative complications were evaluate d and compared between the 3 groups, especially in the 60 cases that underwent N issen fundoplication. P < .05 was considered a significant difference. Results Complications such as gastrointestinal perforation and wound infection were obse rved in 15 (9.7%), 15 (15.6%), and 32 (9.6%) infants of groups S, M, and L , respectively. There were no significant differences in complication rates amon g the 3 groups. However, in Nissen fundoplication, 5 of 15 patients in group S h ad complications, thereby sig nificantly increasing the complication rate as compared with group L (1 of 23, P = .04). Major complications in group S were gastrointestinal perforation and vagal nerve injury. Conclusions Laparoscopic surgery is feasible even in small infants. However, in Nissen fundoplication, special attention is necessary to av oid severe intraoperative complications.展开更多
文摘Purpose The difficulty of performing laparoscopic surgery in small infants rem ains a common complaint of pediatric surgeons. The aim of this study was to eval uate the complications of laparoscopic surgery in small infants weighing less th an 5 kg. Methods Since 1997, 154 infants weighing less than 5 kg underwent lapar oscopic surgery (group S). During that same period, 96 infants weighing less tha n 10 kg (group M)-and 335 children weighing more than 10 kg (group L) also unde rwent laparoscopic surgery. Intra-and postoperative complications were evaluate d and compared between the 3 groups, especially in the 60 cases that underwent N issen fundoplication. P < .05 was considered a significant difference. Results Complications such as gastrointestinal perforation and wound infection were obse rved in 15 (9.7%), 15 (15.6%), and 32 (9.6%) infants of groups S, M, and L , respectively. There were no significant differences in complication rates amon g the 3 groups. However, in Nissen fundoplication, 5 of 15 patients in group S h ad complications, thereby sig nificantly increasing the complication rate as compared with group L (1 of 23, P = .04). Major complications in group S were gastrointestinal perforation and vagal nerve injury. Conclusions Laparoscopic surgery is feasible even in small infants. However, in Nissen fundoplication, special attention is necessary to av oid severe intraoperative complications.
