title: Laparoscopic management for non-traumatic colon perforation in children.
abstract: OBJECTIVE
  Although recent reports have seen an increase in acceptance of laparoscopic surgery as treatment for traumatic colon injury, its role in the management of non-traumatic colon perforation in children has not been reported. In this study, we review our experience in laparoscopic non-resectional management for children who presented with non-traumatic colonic perforation.
  
  
  METHODS
  Between October 2003 and May 2011, 15 children who had been diagnosed with colonic perforation and underwent laparoscopic surgery were included in the study. Their medical records were reviewed for analysis.
  
  
  RESULTS
  The clinical manifestation of non-traumatic colon perforation in children was non-specific. The most likely aetiology was infective colitis. Solitary perforation at the caecum was the most common finding. The exact perforation site could not be identified in 3 patients. Nine patients had primary closure while 3 patients underwent wedge resection. The single trocar laparoscopic surgery was successful in 12 patients. The mean postoperative hospital stay was 7.3 days.
  
  
  CONCLUSIONS
  For children presenting with suspected non-traumatic colon perforation, laparoscopic management is the desirable approach. The peritoneal lavage, wedge excision and primary repair can be performed with single trocar techniques and is associated with minimal morbidity. Future prospective studies are needed to compare this minimally invasive approach with conventional open surgery.
authors.affiliation: Department of Paediatric Surgery, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, Singapore.
authors.forename: Li Wei
authors.initials: LW
authors.lastname: Chiang
authors.forename: Shin-Yi
authors.initials: SY
authors.lastname: Lee
mesh_terms: D002648:Child; D002675:Child, Preschool; D003108:Colonic Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D007416:Intestinal Perforation / Q000000981:diagnostic imaging / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods; D007902:Length of Stay; D008297:Male; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome