Complications of laparoscopic surgery in neonates and small infants.
OBJECTIVE
The difficulty of performing laparoscopic surgery in small infants remains a common complaint of pediatric surgeons. The aim of this study was to evaluate the complications of laparoscopic surgery in small infants weighing less than 5 kg.


METHODS
Since 1997, 154 infants weighing less than 5 kg underwent laparoscopic surgery (group S). During that same period, 96 infants weighing less than 10 kg (group M) and 335 children weighing more than 10 kg (group L) also underwent laparoscopic surgery. Intra- and postoperative complications were evaluated and compared between the 3 groups, especially in the 60 cases that underwent Nissen fundoplication. P < .05 was considered a significant difference.


RESULTS
Complications such as gastrointestinal perforation and wound infection were observed 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 among the 3 groups. However, in Nissen fundoplication, 5 of 15 patients in group S had complications, thereby significantly 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 avoid severe intraoperative complications.
Iwanaka
Tadashi
T
Department of Pediatric Surgery, Saitama Children's Medical Center, Iwatsuki, Saitama, Japan.
Uchida
Hiroo
H
Kawashima
Hiroshi
H
Nishi
Akira
A
Kudou
Sumi
S
Satake
Ryosuke
R
D000293:Adolescent; D000328:Adult; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010535:Laparoscopy / Q000009:adverse effects*