TY - JOUR
T1 - Open Versus Laparoscopic Right Hemicolectomies in Pediatric Patients with Crohn's Disease
AU - Quiroz, Hallie J.
AU - Perez, Eduardo A.
AU - El Tawil, Rana A.
AU - Willobee, Brent A.
AU - Galvez-Cabezas, Kevin
AU - Ferrantella, Anthony R.
AU - Thorson, Chad M.
AU - Langshaw, Amber H.
AU - Sola, Juan E.
N1 - Publisher Copyright:
© 2020, Mary Ann Liebert, Inc., publishers.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/7/1
Y1 - 2020/7/1
N2 - Introduction: Surgery remains an important treatment modality for the management of pediatric Crohn's disease (CD). The objective of this study was to perform a comparative analysis of open right hemicolectomy (ORH) and laparoscopic right hemicolectomy (LRH) for the management of pediatric CD. Materials and Methods: The Kids' Inpatient Database (KID) was queried (2009-2012) for ICD-9 procedure codes for ORH (45.73) and LRH (17.33) in patients with CD (ICD-9 codes: 555.0, 555.1, 555.2, 555.9). Open and laparoscopic procedures were compared using propensity score (PS)-matched analysis (PSMA) of 41 variables. Results: Overall 889 patients were identified and after PS matching, there were 380 ORHs and 380 LRHs. There were zero in-hospital deaths (0/821). ORH patients were more likely to have septicemia, respiratory compromise, pneumonia, perforation and/or laceration, complications, and require blood transfusions (all, P <.05). Although LRH patients were more likely to develop postoperative nausea/vomiting/diarrhea (P <.0001), they had a shorter hospital length of stay (P <.0001) and lower overall hospital charges and cost (P <.001). Conclusion: ORH and LRH in KID have similar low in-hospital mortality in pediatric CD. However, ORH was associated with higher morbidity including an increased risk for respiratory complications, surgical complications, need for blood transfusions, and increased resource utilization than patients who had laparoscopic procedures. In select patients, LRH is safe, feasible, and potentially superior to ORH.
AB - Introduction: Surgery remains an important treatment modality for the management of pediatric Crohn's disease (CD). The objective of this study was to perform a comparative analysis of open right hemicolectomy (ORH) and laparoscopic right hemicolectomy (LRH) for the management of pediatric CD. Materials and Methods: The Kids' Inpatient Database (KID) was queried (2009-2012) for ICD-9 procedure codes for ORH (45.73) and LRH (17.33) in patients with CD (ICD-9 codes: 555.0, 555.1, 555.2, 555.9). Open and laparoscopic procedures were compared using propensity score (PS)-matched analysis (PSMA) of 41 variables. Results: Overall 889 patients were identified and after PS matching, there were 380 ORHs and 380 LRHs. There were zero in-hospital deaths (0/821). ORH patients were more likely to have septicemia, respiratory compromise, pneumonia, perforation and/or laceration, complications, and require blood transfusions (all, P <.05). Although LRH patients were more likely to develop postoperative nausea/vomiting/diarrhea (P <.0001), they had a shorter hospital length of stay (P <.0001) and lower overall hospital charges and cost (P <.001). Conclusion: ORH and LRH in KID have similar low in-hospital mortality in pediatric CD. However, ORH was associated with higher morbidity including an increased risk for respiratory complications, surgical complications, need for blood transfusions, and increased resource utilization than patients who had laparoscopic procedures. In select patients, LRH is safe, feasible, and potentially superior to ORH.
KW - Crohn's disease
KW - laparoscopy
KW - pediatric
KW - right hemicolectomy
UR - http://www.scopus.com/inward/record.url?scp=85088016528&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85088016528&partnerID=8YFLogxK
U2 - 10.1089/lap.2019.0814
DO - 10.1089/lap.2019.0814
M3 - Article
C2 - 32301642
AN - SCOPUS:85088016528
VL - 30
SP - 820
EP - 825
JO - Journal of Laparoendoscopic and Advanced Surgical Techniques
JF - Journal of Laparoendoscopic and Advanced Surgical Techniques
SN - 1092-6429
IS - 7
ER -