Merieme Habti1, Shin Miyata2, Julien Côté2, Lucas Krauel3, Nelson Piché4. 1. Université de Montréal, CHU Ste-Justine, 3175 chemin cote Ste-Catherine, Montréal, QC, H3T 1C5, Canada. 2. Département de Chirurgie, Université de Montréal, CHU Ste-Justine, 3175 chemin cote Ste-Catherine, Montréal, QC, H3T 1C5, Canada. 3. Pediatric Surgery Department, Universitat de Barcelona, Hospital Sant Joan de Deu, Passaig Sant Joan de Deu 2, 08950, Barcelona, Spain. 4. Pediatric Surgery Department, Université de Montréal, CHU Ste-Justine, 3175 Chemin cote Ste-Catherine, Montréal, QC, H3T 1C5, Canada. Nelson.piche.med@ssss.gouv.qc.ca.
Abstract
INTRODUCTION: Pediatric bowel obstruction after intra-abdominal cancer surgery is relatively frequent. Few publications have specifically addressed this significant complication. The purpose of this study was to assess the frequency, etiology and treatment options of bowel obstructions following abdominal cancer surgery in children using our institutional database. MATERIALS AND METHODS: We retrospectively analyzed a single tertiary pediatric hospital database over a 10-year period. The clinical characteristics of patients with and without bowel obstruction were compared using bivariate analyses. The details of the conservative and operative management of bowel obstructions were evaluated. RESULTS: Out of 130 eligible patients, 18 (13.8%) developed bowel obstruction in a mean follow-up of 5.7 years. Patients who developed bowel obstruction were more likely to have received preoperative radiation therapy (16.7 vs 2.7%, p = 0.036) and had longer operative time (398 vs 268 min, p = 0.022). Non-operative management was successful in 39% of patients (7/18). When patients needed surgical intervention, minimally invasive approach was attempted and successfully performed in 36% of cases (4/11), none of which required conversion to laparotomy nor presented with recurrent bowel obstruction. CONCLUSION: Bowel obstruction is a frequent complication after abdominal cancer surgery in children. Conservative management is frequently successful. For patients requiring surgical treatment, laparoscopy remains a valuable option and should be considered in selected cases.
INTRODUCTION: Pediatric bowel obstruction after intra-abdominal cancer surgery is relatively frequent. Few publications have specifically addressed this significant complication. The purpose of this study was to assess the frequency, etiology and treatment options of bowel obstructions following abdominal cancer surgery in children using our institutional database. MATERIALS AND METHODS: We retrospectively analyzed a single tertiary pediatric hospital database over a 10-year period. The clinical characteristics of patients with and without bowel obstruction were compared using bivariate analyses. The details of the conservative and operative management of bowel obstructions were evaluated. RESULTS: Out of 130 eligible patients, 18 (13.8%) developed bowel obstruction in a mean follow-up of 5.7 years. Patients who developed bowel obstruction were more likely to have received preoperative radiation therapy (16.7 vs 2.7%, p = 0.036) and had longer operative time (398 vs 268 min, p = 0.022). Non-operative management was successful in 39% of patients (7/18). When patients needed surgical intervention, minimally invasive approach was attempted and successfully performed in 36% of cases (4/11), none of which required conversion to laparotomy nor presented with recurrent bowel obstruction. CONCLUSION: Bowel obstruction is a frequent complication after abdominal cancer surgery in children. Conservative management is frequently successful. For patients requiring surgical treatment, laparoscopy remains a valuable option and should be considered in selected cases.
Authors: Arin L Madenci; Stacey Fisher; Lisa R Diller; Robert E Goldsby; Wendy M Leisenring; Kevin C Oeffinger; Leslie L Robison; Charles A Sklar; Marilyn Stovall; Rita E Weathers; Gregory T Armstrong; Yutaka Yasui; Christopher B Weldon Journal: J Clin Oncol Date: 2015-08-10 Impact factor: 44.544
Authors: Katie Love Bower; Daniel I Lollar; Sharon L Williams; Farrell C Adkins; David T Luyimbazi; Curtis E Bower Journal: Surg Clin North Am Date: 2018-08-07 Impact factor: 2.741