J. B. Mahida1,2, L. Asti1, P. C. Minneci1,2, K. J. Deans1,2, B. C. Nwomeh2 1Nationwide Children’s Hospital,Center For Surgical Outcomes Research,Columbus, OH, USA 2Nationwide Children’s Hospital,Division Of Pediatric Surgery,Columbus, OH, USA
Introduction: To compare 30-day outcomes between laparoscopic and open intestinal resection in pediatric patients with Crohn’s disease using a validated national database.
Methods: We identified all small intestine resections and partial colectomies with or without ileal resection for Crohn’s disease in the 2012 National Surgical Quality Improvement Program Pediatric (NSQIP Pediatric) database and compared demographic, clinical, and 30-day outcome characteristics between patients who underwent an open or laparoscopic resection.
Results: Of the 89 patients with Crohn’s disease who underwent an intestinal resection, 30 (34%) were performed open and 59 (66%) laparoscopically. In comparison to patients undergoing laparoscopic resection, patients undergoing open resection were more likely to be classified as American Society of Anesthesia class 3 or greater (50% vs. 25%, p=0.020). There were no significant differences in the proportion of patients undergoing operations longer than 3 hours (open vs. laparoscopic, p-value) (30% vs. 36%, p=0.598), in postoperative length of stay (median 5 vs. 5 days, p=0.472), and in all reported NSQIP-Pediatric 30-day outcomes.
Conclusion: In children undergoing intestinal resection for Crohn’s disease, laparoscopic resections are more common with open procedures more likely to be performed in patients who are more severely ill. Overall, there were no significant differences in 30-day outcomes between laparoscopic or open resections. Additional accrual of cases within NSQIP-Pediatric will allow for future risk-adjusted analyses of outcomes.