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Risk Factors for Intestinal Obstruction After Ladd Procedure.

Mitsunaga T, Saito T, Terui K, Nakata M, Ohno S, Mise N, Oita S, Yoshida H - Pediatr Rep (2015)

Bottom Line: Among the cases with intestinal obstruction, 13 (59.1%) showed intestinal ischemia at the initial operation; this incidence was notably high, although it is low when only those cases with another concurrent surgical digestive disease are considered.All cases of intestinal obstruction were caused not by recurrent volvulus, but by adhesion between the intestine and the mesentery.The risk of intestinal obstruction after the Ladd procedure, on the other hand, is high.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric Surgery, Graduate School of Medicine, Chiba University , Japan.

ABSTRACT
Intestinal obstruction is a common complication after Ladd procedure. Ninety-three cases who had undergone the Ladd procedure between 1977 and 2013 treated at our own institution were retrospectively reviewed to identify the causes and risk factors for intestinal obstruction. The Ladd procedure has been performed without any intestinal fixing. Of the 87 cases who survived to discharge, intestinal obstruction was observed in 22 (25.3%). Among the cases with intestinal obstruction, 13 (59.1%) showed intestinal ischemia at the initial operation; this incidence was notably high, although it is low when only those cases with another concurrent surgical digestive disease are considered. All cases of intestinal obstruction were caused not by recurrent volvulus, but by adhesion between the intestine and the mesentery. Intestinal fixing is not required to prevent recurrent volvulus, but it is important to achieve adequate widening of the mesenteric base. The risk of intestinal obstruction after the Ladd procedure, on the other hand, is high. Moreover, patients with intestinal ischemia have an increased risk of intestinal obstruction.

No MeSH data available.


Related in: MedlinePlus

Timing of the appearance of postoperative intestinal obstruction.
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fig001: Timing of the appearance of postoperative intestinal obstruction.

Mentions: Among the 87 cases that survived to discharge, postoperative intestinal obstruction was observed at least once in 22 cases (25.3%), and three or more times in 12 cases. Twelve cases needed further surgery such as adhesiolysis or enterectomy (Table 2). The timing of the appearance of intestinal obstruction is shown in Figure 1. Most cases of first intestinal obstruction developed within two years following the Ladd procedure, though a few cases developed in the late period, after more than 10 years had passed.


Risk Factors for Intestinal Obstruction After Ladd Procedure.

Mitsunaga T, Saito T, Terui K, Nakata M, Ohno S, Mise N, Oita S, Yoshida H - Pediatr Rep (2015)

Timing of the appearance of postoperative intestinal obstruction.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4508621&req=5

fig001: Timing of the appearance of postoperative intestinal obstruction.
Mentions: Among the 87 cases that survived to discharge, postoperative intestinal obstruction was observed at least once in 22 cases (25.3%), and three or more times in 12 cases. Twelve cases needed further surgery such as adhesiolysis or enterectomy (Table 2). The timing of the appearance of intestinal obstruction is shown in Figure 1. Most cases of first intestinal obstruction developed within two years following the Ladd procedure, though a few cases developed in the late period, after more than 10 years had passed.

Bottom Line: Among the cases with intestinal obstruction, 13 (59.1%) showed intestinal ischemia at the initial operation; this incidence was notably high, although it is low when only those cases with another concurrent surgical digestive disease are considered.All cases of intestinal obstruction were caused not by recurrent volvulus, but by adhesion between the intestine and the mesentery.The risk of intestinal obstruction after the Ladd procedure, on the other hand, is high.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric Surgery, Graduate School of Medicine, Chiba University , Japan.

ABSTRACT
Intestinal obstruction is a common complication after Ladd procedure. Ninety-three cases who had undergone the Ladd procedure between 1977 and 2013 treated at our own institution were retrospectively reviewed to identify the causes and risk factors for intestinal obstruction. The Ladd procedure has been performed without any intestinal fixing. Of the 87 cases who survived to discharge, intestinal obstruction was observed in 22 (25.3%). Among the cases with intestinal obstruction, 13 (59.1%) showed intestinal ischemia at the initial operation; this incidence was notably high, although it is low when only those cases with another concurrent surgical digestive disease are considered. All cases of intestinal obstruction were caused not by recurrent volvulus, but by adhesion between the intestine and the mesentery. Intestinal fixing is not required to prevent recurrent volvulus, but it is important to achieve adequate widening of the mesenteric base. The risk of intestinal obstruction after the Ladd procedure, on the other hand, is high. Moreover, patients with intestinal ischemia have an increased risk of intestinal obstruction.

No MeSH data available.


Related in: MedlinePlus