Mitrofanoff procedure safe in kids

Previous abdominal surgery (PAS) does not seem to affect the safety of the laparoscopic-assisted Mitrofanoff procedure in children, a new study has shown.

Researchers retrospectively reviewed data on 34 eligible paediatric patients who received the laparoscopic assisted Mitrofanoff procedure; 15 had undergone PAS (median age, 6.5 years), while the remaining 19 had not (median age, 9.9 years). Outcomes included perioperative factors such as estimated blood loss, hospital stay, stomal stenosis, urinary incontinence and unanticipated need for additional operations.

Operative time (p=0.256), blood loss (p=0.089) and length of hospital stay (p=0.302) were all statistically comparable between the children with vs without PAS. The same was true for median follow-up time (p=0.477). Stoma continence (p=0.634) and the number of patients with stoma stenosis (p=0.672) were both likewise comparable between groups.

Children in the PAS group were more likely to need further intervention, though the difference failed to reach statistical significance (47.4 percent vs 20 percent). All of the PAS patients who required further interventions had a functioning Mitrofanoff conduit at the last follow-up.

“This investigation supports the use of a minimally invasive approach in this patient population as it is feasible, comparable and safe. However, considerations to possible associated benefits and risks in certain subgroups, such as those who had [received ventriculoperitoneal] shunt, is required,” the researchers said.

“This study provides valuable insight into performing laparoscopic operations in children who have undergone prior surgeries and invites future studies to compare the outcomes between patients undergoing open, pure laparoscopic and robotic assisted laparoscopic Mitrofanoff procedures for children with PAS,” they added.