Single-Incision paediatric laparoscopy-Assisted for the treatment of postnecrotizing enterocolitis colonic strictures: a single-centre retrospective study

Abstract

Objectives: The growing adoption of single-incision paediatric laparoscopy (SIPL) by paediatric surgeons is attributed to its potential for minimizing surgical trauma. This study aims to evaluate the benefits of using the SIPL technique for the treatment of postnecrotizing enterocolitis (post-NEC) colonic strictures, with a focus on clinical outcomes and complication rates. Methods: In a retrospective cohort study at a single centre, infants with post-NEC colonic stricture who underwent SIPL surgery were compared with those who had open surgery (OS) between January 2018 and December 2023. This study analyses the demographic and operative characteristics of patients with post-NEC colonic strictures who underwent either SIPL or OS, focusing on conversion rates and postoperative complications. The data were systematically entered into Microsoft Excel, and the statistical analyses were conducted via SPSS version 22.0. Results: This study included 119 patients who were diagnosed with post-NEC colonic stricture. Among these patients, 47 were categorized into the SIPL group, whereas 72 patients were assigned to the OS group. Statistical analysis revealed no significant differences between the two groups concerning gestational age, birth weight, age and weight at the time of surgery, or anaesthetic risk. The median operative time was notably shorter in the SIPL group than in the OS group (150 min vs. 175 min, P = 0.0089). Additionally, the estimated blood loss was significantly lower in the SIPL group than in the OS group (5 ml vs. 10 ml, P = 0.0001). Furthermore, the SIPL group demonstrated a significantly shorter duration to the initiation of feeds than the OS group (5 days vs. 6 days, P = 0.0049). In the SIPL group, the incidence rates of incisional hernia and incisional infection were lower than those in the OS group; however, these differences did not reach statistical significance (8.51% vs. 12.5%, P = 0.70 and 10.64% vs. 15.28%, P = 0.53, respectively). Additionally, no statistically significant differences were observed between the two groups in the incidence of anastomotic stricture/leakage or adhesive intestinal obstruction (8.51% vs. 13.89%, P = 0.37). Conclusion: The SIPL procedure for the treatment of post-NEC colonic strictures demonstrates an efficacy and safety comparable to those of OS and also offers potential cosmetic benefits.