Utility and safety of laparoscopy for intra-abdominal cysts in small children: Single center experience

Abstract

Objectives: The objective of this study is to study the utility and safety of laparoscopy in the management of intra-abdominal cysts in small children. Materials and Methods: This is a retrospective analysis of patient data that underwent laparoscopy for intra-abdominal cystic lesions. The study period was from March 2010 to April 2015. Patients with adequate follow-up and complete data were included for study. The patients were divided into 3 age groups for analysis of the outcome viz. neonates, infants, and children between 1 and 5 years of age. The data were analyzed for spectrum of lesions managed, surgical procedure performed, operative time, intraoperative events, need for conversion, time to discharge, and the overall outcome. Results: A total of 106/121 patients with adequate follow-up are included for the study and most of the patients (63.6%) belonged to children between 1 to 5 years. Wide spectrums of lesions were managed laparoscopically, and majority 45 (42.4%) had cysts arising from the hepatobiliary system whereas genitourinary system lesions formed 2nd largest group with 21 (19.8%) patients. The procedure was completed laparoscopically in 86.6% (92) of the patients. The morbidity including wound infection, re-exploration, and recurrences, were seen in 5% of patients. The average duration of hospital stay was 4.6 days (range 2-21 days), and the average duration of follow-up was 96 months (range 6-180 months). Conclusion: Laparoscopic surgery is a fascinating technical development for pediatric surgeons. It is applicable for the wide variety of intra-abdominal cystic lesions in children. Excisional surgeries are best performed by laparoscopic technique even in small infants and neonates. In the hands of experienced surgeons, reconstructive surgeries have good outcome with minimal morbidity.