Malrotation Correction in the Adult Population
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Read the article on pubmed.ncbi.nlm.nih.gov ↗Article · Nov 2020 · 1 min read
In brief
In brief
NSQIP analysis of 220 adult patients undergoing Ladd procedure for malrotation shows low mortality (1.36%) and similar outcomes whether appendectomy is performed concurrently or not. Most patients were female (68%), with mean hospital stay under 5 days and 95% discharged home, suggesting safe surgical correction in adults.
Written by the GCMD Library team from the article.
Background: Malrotation is a congenital anomaly most often affecting the pediatric population. The Ladd procedure is the standard treatment for this pathology. Well-studied in the pediatric population, large studies of the demographics and outcomes of patients who reach adulthood are lacking.
Methods: An analysis of the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database (2015-2018) was performed, capturing patients with a post-operative diagnosis of malrotation and who underwent surgical correction with or without appendectomy, excluding those who underwent other major procedures such as colectomy. Baseline demographics and outcomes were compared. The primary outcome was mortality. Secondary outcomes such as length of stay and discharge destination were included.
Results: Two hundred twenty patients undergoing surgical correction of malrotation were captured, all of which were performed by a general surgeon under general anesthesia. One hundered and nine (49.55%) of these patients also underwent an appendectomy. Most of these patients were female (68.18%). Comorbidities and perioperative variables were clinically similar. Operative time was similar between the two groups (112 ± 86 vs. 98 ± 49 min, p = 0.1385). Thirty-day mortality (1.36%), length of stay (4.79 ± 6.21 days), readmission rate (13.64%), wound infection (2.27%) and discharge destination (95.00% to home) were statistically similar between groups.
Conclusions: The data describes demographics and outcomes in adults undergoing Ladd procedures with and without appendectomy. Immediate outcomes may be equivalent regardless of incidental appendectomy. Further work is necessary to describe the population of adults with malrotation reaching adulthood.
DOI: 10.1007/s00268-020-05790-x