Faculty Collaboration Database

Laparoscopic versus open abdominal surgery in children with sickle cell disease is associated with a shorter hospital stay. Pediatr Blood Cancer 2008 Mar;50(3):603-6

Date

05/08/2007

Pubmed ID

17480009

DOI

10.1002/pbc.21245

Scopus ID

2-s2.0-38549136787 (requires institutional sign-in at Scopus site)   32 Citations

Abstract

BACKGROUND: Limited information exists comparing the post-operative complication rate of laparoscopic or open abdominal surgeries in children with sickle cell disease (SCD). The primary objective of this study was to compare the outcomes in children with SCD who required laparoscopic or open abdominal surgery for a cholecystectomy or splenectomy.

PROCEDURE: We conducted a retrospective analysis of laparoscopic and open abdominal surgeries performed in children with SCD (ages 0-20 years) at two medical centers from 1984 to 2004. The primary outcome measures were the rates of post-operative pain and acute chest syndrome (ACS) episodes following laparoscopic or open abdominal surgery. The secondary outcome was length of hospital stay following surgery. We also examined the potential contribution of pre-operative (transfusion) and intra-operative factors (operating time, estimated blood loss, and end-operative temperature) to post-operative SCD-related complications.

RESULTS: A total of 140 cases were identified, 98 laparoscopic and 42 open. Episodes of post-operative pain and ACS episodes were comparable between laparoscopic and open procedures (pain: 4% vs. 3%, P = 0.619; ACS: 5% vs. 5%, P = 0.933). Additionally, laparoscopic surgeries were associated with a significantly shorter hospital stay (2.9 vs. 5.4 days, 95% CI -3.7 to -1.4, P < 0.001). There was no difference in the number of hospital readmissions within 1 month of the surgery.

CONCLUSIONS: For children with SCD who need a cholecystectomy or splenectomy, laparoscopy is the preferred strategy because of a shorter hospital stay with a similar complication rate compared to open surgeries.

Author List

Goers T, Panepinto J, Debaun M, Blinder M, Foglia R, Oldham KT, Field JJ

Author

Joshua J. Field MD Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Acute Disease
Adolescent
Anemia, Sickle Cell
Blood Loss, Surgical
Blood Transfusion
Body Temperature
Chest Pain
Child
Child, Preschool
Cholecystectomy
Cholecystectomy, Laparoscopic
Elective Surgical Procedures
Emergencies
Female
Humans
Laparoscopy
Length of Stay
Male
Pain, Postoperative
Preoperative Care
Splenectomy
Syndrome