Heterotaxy syndrome and intestinal rotational anomalies: Impact of the Ladd procedure

Journal of Pediatric Surgery
Arash SalavitabarWyman W Lai

Abstract

Children with heterotaxy syndrome and intestinal rotational anomalies (IRA) are at risk for midgut volvulus and ischemia. Controversy exists regarding risks and benefits of prophylactic Ladd procedures. The purpose of this study is to assess the impact of Ladd procedures on adverse events for children with heterotaxy and IRA. A retrospective cohort study using the Pediatric Health Information System (PHIS) database was performed. All children with heterotaxy and IRA admitted at age ≤30days and discharged between 1/1/2004 and 1/1/2011 were included with a minimum 2-year follow-up period. The primary outcome was major morbidity, defined as a composite variable for intestinal obstruction/volvulus, ischemia, or resection, or inhospital mortality. Univariable and multivariable analyses were performed. There were 325 patients who met the inclusion criteria, including 92 (28%) patients with single ventricles. Mean gestational age was 38.0±2.1weeks and birth weight was 3.1±0.6kg. Ladd procedure was performed during initial hospitalization on 188 (58%) children. In multivariable analyses, Ladd procedure on initial hospitalization was associated with a 2.2 times increased odds of adverse events on subsequent admissions (95% CI 1.3-4.0, p...Continue Reading

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Citations

Sep 29, 2015·Journal of Pediatric Surgery·Paul S CullisPaul D Losty
Nov 16, 2016·Current Treatment Options in Cardiovascular Medicine·Karl Degenhardt, Jack Rychik
Feb 1, 2018·Clinics and Practice·Stéphanie CupersMarie-Christine Seghaye
May 31, 2021·The American Journal of the Medical Sciences·Muhammad SoofiVaskar Mukerji
Sep 3, 2021·Cardiology in the Young·Anastasia FotakiJulene S Carvalho

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