Laparoscopic treatment of postnecrotizing enterocolitis colonic strictures.
The current report is a multicenter study of a series of infants who developed colonic strictures (CS) as a sequelae of necrotizing enterocolitis (NEC) and who were treated successfully with laparoscopic intestinal resection and primary anastomosis. During 2005-2008, 11 neonates (gestational ages, 32-38 weeks), with a mean birth weight of 1.7 kg (range, 0.96-2.2) and a mean weight at operation of 3.04 kg (range, 1.6-4.4 were approached laparoscopically, following the diagnosis of a post-NEC-CS. The two surgical techniques were: 1) laparoscopic mobilization with extracorporeal resection and anastomosis (LERA) in 4 (36%) and 2) laparoscopic mobilization with intracorporeal resection and anastomosis (LIRA) in 7 (64%) patients. Laparoscopy was effectively performed in all cases without conversion to open surgery. The median operative time was 93 minutes (range, 80-121). The anastomosis was colocolic in all patients, except in 1 case, in which it was colorectal. There were no operative complications. All babies recovered uneventfully and started oral feeding at a median time of 3.5 days (range, 1-11) postoperatively. Hospital discharge was at a median time of 9 days (range, 2-29) following operation. No recurrent strictures have developed.
Martinez-Ferro
Marcelo
M
Department of Pediatric Surgery, Fundación Hospitalaria, Hospital Privado de Niños, Buenos Aires, Argentina. martinezferro@fibertel.com.ar
Rothenberg
Steven
S
St Peter
Shawn
S
Bignon
Horacio
H
Holcomb
George
G
D000714:Anastomosis, Surgical; D003108:Colonic Diseases / Q000209:etiology / Q000601:surgery*; D003251:Constriction, Pathologic; D020345:Enterocolitis, Necrotizing / Q000150:complications*; D006801:Humans; D007231:Infant, Newborn; D007422:Intestines / Q000601:surgery*; D010535:Laparoscopy; D012189:Retrospective Studies