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Outcomes After Ladd Procedures for Intestinal Malrotation in Newborns with Heterotaxy Syndrome.
- Source :
-
Journal of pediatric surgery [J Pediatr Surg] 2023 Jun; Vol. 58 (6), pp. 1095-1100. Date of Electronic Publication: 2023 Feb 17. - Publication Year :
- 2023
-
Abstract
- Purpose: Intestinal malrotation may be asymptomatic in patients with heterotaxy syndrome (HS), and whether these newborns benefit from prophylactic Ladd procedures is unknown. This study sought to uncover nationwide outcomes of newborns with HS receiving Ladd procedures.<br />Methods: Newborns with malrotation were identified from the Nationwide Readmission Database (2010-2014) and stratified into those with and without HS utilizing ICD-9CM codes for situs inversus (759.3), asplenia or polysplenia (759.0), and/or dextrocardia (746.87). Outcomes were analyzed using standard statistical tests.<br />Results: 4797 newborns with malrotation were identified, of which 16% had HS. Ladd procedures were performed in 70% overall and more common in those without heterotaxy (73% vs. 56% HS). Ladd procedures in newborns with heterotaxy were associated with higher complications compared to those without HS including surgical site reopening (8% vs. 1%), sepsis (9% vs. 2%), infections (19% vs. 11%), venous thrombosis (9% vs. 1%), and prolonged mechanical ventilation (39% vs. 22%), all p < 0.001. HS newborns were less frequently readmitted with bowel obstructions (0% vs. 4% without HS, p < 0.001) with no readmissions for volvulus in either group.<br />Conclusion: Ladd procedures in newborns with heterotaxy were associated with increased complications and cost without differences in rates of volvulus and bowel obstruction on readmission.<br />Type of Study: Retrospective Comparative.<br />Level of Evidence: III.<br />Competing Interests: Conflict of interest None.<br /> (Copyright © 2023 Elsevier Inc. All rights reserved.)
- Subjects :
- Humans
Infant, Newborn
Retrospective Studies
Heterotaxy Syndrome surgery
Heterotaxy Syndrome complications
Intestinal Volvulus surgery
Intestinal Volvulus complications
Intestinal Obstruction surgery
Intestinal Obstruction complications
Cardiovascular Abnormalities complications
Digestive System Abnormalities epidemiology
Digestive System Abnormalities surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1531-5037
- Volume :
- 58
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Journal of pediatric surgery
- Publication Type :
- Academic Journal
- Accession number :
- 36941169
- Full Text :
- https://doi.org/10.1016/j.jpedsurg.2023.02.013