Enucleation for intestinal duplications: a comparative study with intestinal resection and anastomosis
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In brief
In brief
This retrospective study of 51 pediatric patients demonstrates that duplication enucleation offers significant advantages over traditional intestinal resection for intestinal duplications, including faster return to feeding (1 vs 3 days) and shorter hospital stays (4 vs 6 days) without increased complications.
- Duplication enucleation allows faster return to feeding (1 vs 3 days) and shorter hospital stay (4 vs 6 days) compared to resection-anastomosis.
- Enucleation can be performed laparoscopically in select cases, offering minimally invasive treatment for intestinal duplications.
- Histological analysis showed 68% of resected duplications had muscular layer, suggesting enucleation is anatomically feasible in most cases.
- Enucleation does not increase postoperative complications compared to traditional resection with anastomosis.
- Prenatal detection of cystic lesions was more common in enucleation cases (70%) versus resection cases (46%), though not statistically significant.
Written by the GCMD Library team from the article.
Abstract
Purpose
Duplication enucleation (DE) has been described as an alternative to intestinal resection with primary anastomosis (IRA) for intestinal duplications, but no comparative study exists. The aim of this study was to compare both surgical procedures for intestinal duplication.
Methods
A retrospective study was performed, including all children treated for intestinal duplication (2005–2023). Patients that underwent DE were compared to those that underwent IRA. Statistical significance was determined using p < 0.05. Ethical approval was obtained.
Results
A total of 51 patients (median age: 5 months) were treated for intestinal duplication, including 27 patients (53%) that underwent DE and 24 IRA (47%). A cystic image was detected prenatally in 19 patients (70%) with DE and 11 patients (46%) with IRA (p = 0.09). Enucleation was performed using laparoscopy in 7 patients (14%). Patients that underwent DE had shorter time to first feed (1 vs 3 days, p = 0.0001) and length of stay (4 vs 6 days, p < 0.0004) compared to IRA. A muscular layer was identified in 68% of intestinal resection specimens.
Conclusion
Compared to intestinal resection with anastomosis, duplication enucleation is associated with decreased postoperative length of stay and delay to first feeds without increasing post-operative complications. Regarding histological analysis, enucleation seems feasible in most cases.