Abstract
Introduction
Enteric duplication is a congenital anomaly with varied clinical presentation that requires surgical resection for definitive treatment. This had been approached with laparotomy for resection, but has changed with minimally invasive technique. The purpose of our study was to determine the demographics, natural history, operative interventions, and outcomes of pediatric enteric duplication cysts in a contemporary cohort.
Methods
With IRB approval, we performed a retrospective chart review of all patients less than 18 years old treated for enteric duplication between January 2006 and August 2016. Demographics, patient presentation, operative technique, intraoperative findings, hospital course, and follow-up were evaluated. Descriptive statistical analysis was performed; all medians were reported with interquartile range (IQR).
Results
Thirty-five patients underwent surgery for enteric duplication, with a median age at surgery of 7 months (2.5–54). Median weight was 7.2 kg (6–20). Most common patient presentations included prenatal diagnosis 37% (n = 13). Thirty-four patients (97%) had their cyst approached via minimally invasive technique (thoracoscopy or laparoscopy) with only three (8%) requiring conversion to an open operation. Median operative time was 85 min (54–133) with 27 (77%) patients requiring bowel resection. Median length of bowel resected was 4.5 cm (3–7). Most common site of duplication was ileocecal (n = 15, 42%). Postoperative median hospital length of stay was 3 days (2–5) and median number of days to regular diet was 3 (1–4). No patients required re-operation during their hospital stay. Median follow-up was 25 days (20–38).
Conclusion
In our series, most enteric duplication cysts were diagnosed prenatally. These can be managed via minimally invasive technique with minimal short-term complications, even in neonates and infants.
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Joseph Sujka: concept and design, data collection, data analysis and interpretation, drafting article, critical revision of article, approval of article, and statistics. Justin Sobrino: data collection, data analysis and interpretation, and drafting article. Leo A. Benedict: drafting article, critical revision of article, and statistics. Hanna Alemayehu: concept and design, data collection, data analysis and interpretation, drafting article, critical revision of article, approval of article, and statistics. Shawn D. St. Peter: concept and design, data collection, data analysis and interpretation, drafting article, critical revision of article, approval of article, and statistics. Richard J. Hendrickson: concept and design, data collection, data analysis and interpretation, drafting article, critical revision of article, and approval of article.
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This article does not contain any studies with human participants or animals performed by any of the authors.
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Informed consent was waived by our IRB due to the fact that the data collected for this study were retrospective and de-identified.
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Sujka, J.A., Sobrino, J., Benedict, L.A. et al. Enteric duplication in children. Pediatr Surg Int 34, 1329–1332 (2018). https://doi.org/10.1007/s00383-018-4362-x
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DOI: https://doi.org/10.1007/s00383-018-4362-x