title: Laparoscopic repair of malrotation: what are the indications in neonates and children?
abstract: OBJECTIVE
  To define the role of laparoscopy for treating malrotation in children.
  
  
  METHODS
  The Ladd procedure (9 laparoscopic [lap-Ladd], 17 open [open-Ladd]; n=26) was performed in children up to and including 30 days of age (neonatal [Group N]) and older (Group C). These groups were compared retrospectively.
  
  
  RESULTS
  Group N (n=14) comprised 3 lap-Ladd and 11 open-Ladd patients. Group C (n=12) comprised 6 lap-Ladd and 6 open-Ladd patients. No case had ischemic bowel preoperatively. Intestinal volvulus was confirmed in 3 of 3 lap-Ladd and 9 of 11 open-Ladd patients in Group N, compared with 5 of 6 lap-Ladd and 6 of 6 open-Ladd patients in Group C (P=not significant). Mean operating times were significantly longer for lap-Ladd patients (130.7 minutes versus 81.1 minutes in Group N and 119.2 minutes versus 74.2 minutes in Group C). Conversion to an open-Ladd procedure was necessary in 1 of 3 patients in Group N and 1 of 6 patients in Group C (P=not significant). Complications arose in open-Ladd patients, bowel obstruction in Group N (1 of 11), and mesenteric chylorrhea in Group C (1 of 6). There was recurrence in 1 of 3 lap-Ladd patients in Group N. Mean time to recommence feeding was earlier for lap-Ladd patients (P=not significant). Length of hospitalization was similar in Group N but was shorter for lap-Ladd patients in Group C (P=not significant).
  
  
  CONCLUSIONS
  Although lap-Ladd appears to be a safe procedure, it cannot be recommended for the treatment of malrotation in neonates.
authors: Department of Pediatric Surgery, Shizuoka Children's Hospital , Shizuoka, Japan .
authors: Go
authors: G
authors: Miyano
authors: Hiroaki
authors: H
authors: Fukuzawa
authors: Keiichi
authors: K
authors: Morita
authors: Masakatsu
authors: M
authors: Kaneshiro
authors: Hiromu
authors: H
authors: Miyake
authors: Hiroshi
authors: H
authors: Nouso
authors: Masaya
authors: M
authors: Yamoto
authors: Koji
authors: K
authors: Fukumoto
authors: Naoto
authors: N
authors: Urushihara
mesh_terms: D002648:Child; D002675:Child, Preschool; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D045822:Intestinal Volvulus / Q000150:complications / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods; D007813:Laparotomy; D008297:Male; D061646:Operative Time; D012008:Recurrence; D012189:Retrospective Studies