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Laparoscopic versus open repair of congenital duodenal obstruction: a systematic review and meta-analysis

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Abstract

Purpose

To assess the safety and efficacy of laparoscopic versus open repair of congenital duodenal obstruction (CDO), we conducted a systematic review and meta-analysis (CDO).

Methods

A literature search was conducted to identify studies that compared laparoscopic surgery (LS) and open surgery (OS) for neonates with CDO. Meta-analysis was used to pool and compare variables such as operative time, time to feeding, length of hospital stay, anastomotic leak or stricture, postoperative ileus, wound infection, and overall postoperative complications.

Results

Among the 1348 neonatal participants with CDO in the ten studies, 304 received LS and 1044 received OS. When compared to the OS approach, the LS approach resulted in shorter hospital stays, faster time to initial and full feeding, longer operative time, and less wound infection. However, no significant difference in secondary outcomes such as anastomotic leak or stricture, postoperative ileus, and overall postoperative complications was found between LS and OS.

Conclusions

LS is a safe, feasible and effective surgical procedure for neonatal CDO when compared to OS. Compared with OS, LS has a faster time to feeding, a shorter hospital stay, and less wound infection. Furthermore, in terms of anastomotic leak or stricture, postoperative ileus, and overall postoperative complications, LS is equivalent to OS. We conclude that LS should be considered an acceptable option for CDO.

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Author notes

  1. Jie Zhang and Xiaoqi Xu have equally contributed to the work.

Authors and Affiliations

  1. Department of Pediatric Surgery, Hangzhou Children’s Hospital, Hangzhou, China

    Jie Zhang

  2. Department of Pediatrics, The Fourth Clinical Medical College of Zhejiang, Chinese Medical University, Hangzhou, China

    Xiaoqi Xu, Xiaoman Wang & Yaxin Lv

  3. Department of Pathology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310006, China

    Lingling Zhao

  4. Department of Neonatal Surgery, The Affiliated Children’s Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China

    Kuai Chen

Authors
  1. Jie Zhang
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  2. Xiaoqi Xu
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  3. Xiaoman Wang
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  4. Lingling Zhao
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  5. Yaxin Lv
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  6. Kuai Chen
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Contributions

JZ conception and design of study, drafting the manuscript. XX acquisition of data, drafting the manuscript. XW acquisition of data, drafting the manuscript. LZ drafting the manuscript. YL conception and design of study, analysis and/or interpretation of data. KC conception and design of study, analysis and/or interpretation of data, drafting the manuscript.

Corresponding author

Correspondence to Kuai Chen.

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Zhang, J., Xu, X., Wang, X. et al. Laparoscopic versus open repair of congenital duodenal obstruction: a systematic review and meta-analysis. Pediatr Surg Int 38, 1507–1515 (2022). https://doi.org/10.1007/s00383-022-05209-9

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  • DOI: https://doi.org/10.1007/s00383-022-05209-9

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