Laparoscopic cyst enucleation is a promising technique for treatment of gastrointestinal tract duplications in children

Abstract

BackgroundLaparoscopic cyst enucleation has its advantages and limitations in treatment of gastrointestinal tract (GIT) duplications. It allows to avoid bowel resection in such locations as ileocecal valve. We introduced laparoscopic cyst enucleation with further bowel plasty using cyst muscle layer and without monopolar coagulation, for cyst dissection we used straight scissors. Materials and methodsOur study included 20 children with GIT duplications, who underwent cyst enucleation from 2018 to 2021. Laparoscopy was performed in all cases with various cyst locations (stomach – 2, duodenum – 3, small bowel – 14, ileocecal area – 1). Mean age of surgery was 40 ± 35,3 days (min 6 days, max 150 days). ResultsMean operation time was 84,4 ± 27,35 min (min – 40 min, max – 160 min). We had no intraoperative complications. All patients received parenteral feeding for 3–5 days after the operation. Postoperative complications occurred in 3 cases: bowel perforation which required enterostomy (10%) and bowel volvulus required resection (5%). To our opinion, perforations occurred due to monopolar coagulation used for cyst enucleation in these children. No complications were observed in patients who underwent enucleation by straight scissors. Mean postoperative hospital stay was 15.6 ± 10.48 days (min – 4 days, max – 58 days). We observed neither stenosis nor any other complications in the long-term follow-up. ConclusionsLaparoscopic cyst enucleation is a feasible and safe approach for GIT duplications. It allows to avoid bowel resection, and the use of straight scissors instead of monopolar coagulation provides less postoperative complications such as perforation. The Level of evidenceIII.