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Appendectomy as part of Ladd’s procedure: a systematic review and survey analysis

BACKGROUND: Ladd’s Procedure has been the surgical intervention of choice in the management of congenital intestinal malrotation for the past century. Historically, the procedure included performing an appendectomy to prevent future misdiagnosis of appendicitis, since the location of the appendix wi...

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Autores principales: Al Smady, Montaser Nabeeh, Hendi, Salama Bin, AlJeboury, Sarah, Al Mazrooei, Hessa, Naji, Hussein
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10070202/
https://www.ncbi.nlm.nih.gov/pubmed/37010655
http://dx.doi.org/10.1007/s00383-023-05437-7
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author Al Smady, Montaser Nabeeh
Hendi, Salama Bin
AlJeboury, Sarah
Al Mazrooei, Hessa
Naji, Hussein
author_facet Al Smady, Montaser Nabeeh
Hendi, Salama Bin
AlJeboury, Sarah
Al Mazrooei, Hessa
Naji, Hussein
author_sort Al Smady, Montaser Nabeeh
collection PubMed
description BACKGROUND: Ladd’s Procedure has been the surgical intervention of choice in the management of congenital intestinal malrotation for the past century. Historically, the procedure included performing an appendectomy to prevent future misdiagnosis of appendicitis, since the location of the appendix will be shifted to the left side of the abdomen. This study consists of two parts. A review of the available literature on appendectomy as part of Ladd’s procedure and then a survey sent to pediatric surgeons about their approach (to remove the appendix or not) while performing a Ladd’s procedure and the clinical reasoning behind their approach. METHODS: The study consists of 2 parts: (1) a systematic review was performed to extract articles that fulfill the inclusion criteria; (2) a short online survey was designed and sent by email to 168 pediatric surgeons. The questions in the survey were centered on whether a surgeon performs an appendectomy as part of the Ladd’s procedure or not, as well as their reasoning behind either choice. RESULTS: The literature search yielded five articles, the data from the available literature are inconsistent with performing appendectomy as part of Ladd's procedure. The challenge of leaving the appendix in place has been briefly described with minimal to no focus on the clinical reasoning. The survey demonstrated that 102 responses were received (60% response rate). Ninety pediatric surgeons stated performing an appendectomy as part of the procedure (88%). Only 12% of pediatric surgeons are not performing appendectomy during Ladd’s procedure. CONCLUSION: It is difficult to implement a modification in a successful procedure like Ladd’s procedure. The majority of pediatric surgeons perform an appendectomy as part of its original description. This study has identified gaps in the literature pertaining to analyze the outcomes of performing Ladd's procedure without an appendectomy which should be explored in future research. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00383-023-05437-7.
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spelling pubmed-100702022023-04-05 Appendectomy as part of Ladd’s procedure: a systematic review and survey analysis Al Smady, Montaser Nabeeh Hendi, Salama Bin AlJeboury, Sarah Al Mazrooei, Hessa Naji, Hussein Pediatr Surg Int Review BACKGROUND: Ladd’s Procedure has been the surgical intervention of choice in the management of congenital intestinal malrotation for the past century. Historically, the procedure included performing an appendectomy to prevent future misdiagnosis of appendicitis, since the location of the appendix will be shifted to the left side of the abdomen. This study consists of two parts. A review of the available literature on appendectomy as part of Ladd’s procedure and then a survey sent to pediatric surgeons about their approach (to remove the appendix or not) while performing a Ladd’s procedure and the clinical reasoning behind their approach. METHODS: The study consists of 2 parts: (1) a systematic review was performed to extract articles that fulfill the inclusion criteria; (2) a short online survey was designed and sent by email to 168 pediatric surgeons. The questions in the survey were centered on whether a surgeon performs an appendectomy as part of the Ladd’s procedure or not, as well as their reasoning behind either choice. RESULTS: The literature search yielded five articles, the data from the available literature are inconsistent with performing appendectomy as part of Ladd's procedure. The challenge of leaving the appendix in place has been briefly described with minimal to no focus on the clinical reasoning. The survey demonstrated that 102 responses were received (60% response rate). Ninety pediatric surgeons stated performing an appendectomy as part of the procedure (88%). Only 12% of pediatric surgeons are not performing appendectomy during Ladd’s procedure. CONCLUSION: It is difficult to implement a modification in a successful procedure like Ladd’s procedure. The majority of pediatric surgeons perform an appendectomy as part of its original description. This study has identified gaps in the literature pertaining to analyze the outcomes of performing Ladd's procedure without an appendectomy which should be explored in future research. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00383-023-05437-7. Springer Berlin Heidelberg 2023-04-03 2023 /pmc/articles/PMC10070202/ /pubmed/37010655 http://dx.doi.org/10.1007/s00383-023-05437-7 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Review
Al Smady, Montaser Nabeeh
Hendi, Salama Bin
AlJeboury, Sarah
Al Mazrooei, Hessa
Naji, Hussein
Appendectomy as part of Ladd’s procedure: a systematic review and survey analysis
title Appendectomy as part of Ladd’s procedure: a systematic review and survey analysis
title_full Appendectomy as part of Ladd’s procedure: a systematic review and survey analysis
title_fullStr Appendectomy as part of Ladd’s procedure: a systematic review and survey analysis
title_full_unstemmed Appendectomy as part of Ladd’s procedure: a systematic review and survey analysis
title_short Appendectomy as part of Ladd’s procedure: a systematic review and survey analysis
title_sort appendectomy as part of ladd’s procedure: a systematic review and survey analysis
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10070202/
https://www.ncbi.nlm.nih.gov/pubmed/37010655
http://dx.doi.org/10.1007/s00383-023-05437-7
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