Laparoscopic surgery in children with congenital heart disease
Journal of Pediatric Surgery, 06/22/2012
Gillory LA et al. – In this review, there were no major contraindications to performing laparoscopic procedures in children with congenital heart disease, and the authors conclude that it is reasonably safe to perform laparoscopic surgery on these children.Methods
- A single-institution, institutional review board–approved, retrospective review was conducted including children younger than 5 years with congenital heart disease who underwent laparoscopic or open abdominal procedures.
- Patient demographics, operative details, complications, and 30-day mortality were examined.
- Over 10 years, 111 children with congenital heart disease underwent 121 laparoscopic procedures.
- Median age was 2.5 months, with 87% being infants. Laparoscopic gastrostomy was the most common procedure (101).
- There was no intraoperative hemodynamic instability, median operative time was 70 minutes, postoperative complications were low (5%), and all children were alive at 30 days.
- Only 8 patients required conversion from laparoscopic to open, all secondary to technical issues, not hemodynamic instability.
- There were 42 children with cardiac disease who underwent 45 open procedures during the study period.
- There were no significant differences between patient demographics, type of procedure, operative time, complications, or 30-day mortality comparing the open and laparoscopic groups.