Prophylactic Colectomy for Children with Familial Adenomatous Polyposis: Resource Utilization and Outcomes for Open and Laparoscopic Surgery

Overview

Journal Transl Gastroenterol Hepatol

Publisher AME Publishing Company

Specialty Gastroenterology

Date 2021 Aug 23

PMID 34423161

Authors

Anthony Ferrantella

Rebecca A Saberi

Brent A Willobee

Hallie J Quiroz

Amber H Langshaw

Samir Pandya

Chad M Thorson

Juan E Sola

Eduardo A Perez

Affiliations

Soon will be listed here.

Abstract

Background: Laparoscopic approach for the surgical management of familial adenomatous polyposis (FAP) has become increasingly common for pediatric patients. The purpose of this study was to compare short-term outcomes and resource utilization between open and laparoscopic surgery for prophylactic colectomy in children with FAP.

Methods: The Kids' Inpatient Database (2009 and 2012) was analyzed for children (age ≤20 years) with FAP that underwent prophylactic total colectomy or proctocolectomy. Patient demographics, treating hospital characteristics, hospital charges, and short-term outcomes were compared according to the surgical technique utilized (open versus laparoscopic).

Results: Overall, we identified 216 patients with FAP that underwent elective total colectomy, of which 95 cases were performed by open surgery and 121 were done laparoscopically. The majority of patients were treated at large, not-for-profit, urban teaching hospitals, and the median age was equal (16 years) in both groups. Complications that were more common for open procedures included accidental perforation or hemorrhage (4% 0%, P=0.023), reopening of surgical site (3% 0%, P=0.049), and pneumonia (3% 0%, P=0.049). Simultaneous proctectomy was performed more commonly in the open cohort (91% 71%, P<0.001) as well as ileostomy creation (74% 49%, P<0.001). The median length of stay was similar in the open and laparoscopic groups (7 6 days, P=0.712). Median total hospital charges were also similar ($67,334 $68,717, P=0.080).

Conclusions: A laparoscopic approach for prophylactic colectomy can be safely performed in children with FAP, and total hospital charges are equivalent compared to open surgery. However, simultaneous proctectomy was performed less often with laparoscopic surgery.

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