Laparoscopic Ladd's surgery for the treatment of congenital intestinal malrotation in infants

Objective To explore the feasibility and effect of laparoscopic Ladd's surgery for the treatment of intestinal malrotation in infants. Methods The clinical data of 50 infants with intestinal malrotation who were admitted to the Wuhan Medical & Health Center for Women and Children from January 2011 to December 2013 were retrospectively analyzed. Of 50 infants, 27 infants receiving the open Ladd's surgery were allocated into the open surgery group and 23 infants receiving the laparoscopic Ladd's surgery were allocated into the laparoscopy group. The operation time, time to anal exsufflation, duration of hospital stay, postoperative incision infection and intestinal obstruction in the 2 groups were observed. All the patients were followed up by outpatient examination or telephone interview till March 2014. The measurement data with normal distribution were presented as±s and analyzed by the t test, and count data were analyzed using the chi-square test or Fisher exact probability. Results The operation time, time to anal exsufflation and duration of hospital stay were (69±7)minutes, (41±9)hours and (10.4±2.4)days in the open surgery group, which was significantly different from (92±13)minutes, (28±5)hours and (6.4±1.5)days in the laparoscopy group (t=6.21, 16.50, 6.34, P<0.05). Two infants had incision infection and 1 infant had intestinal obstruction in the open surgery group. There was no patient with complications in the laparoscopy group. All the patients were followed up for the median time of 13 months (range, 6-24 months), with a good survival and no other symptoms. Conclusion Laparoscopic Ladd's surgery is safe and feasible compared with open surgery, and it could be used as a prior operation method for treatment of intestinal malrotation in infants. Key words: Intestinal malrotation; Ladd's surgery; Laparoscopy