Huang Hua,Ma Shuaijun,Ma Xiaoyu,et al.Preliminary experience with Kareem procedure in the surgical correction of pediatric intestinal malrotation[J].Journal of Clinical Pediatric Surgery,,():771-775.[doi:10.3760/cma.j.cn101785-202501008-012]
Preliminary experience with Kareem procedure in the surgical correction of pediatric intestinal malrotation
- Keywords:
- Gastrointestinal Tract; Digestive System Malformations; Intestinal Volvulus; Surgical Procedures; Operative; Child
- Abstract:
- Objective To preliminarily explore the feasibility and safety of the Kareem procedure in correcting intestinal malrotation in children. Methods A retrospective analysis was conducted on clinical data of 13 pediatric patients with intestinal malrotation treated with the Kareem procedure in the Department of Neonatal Surgery at the Third Affiliated Hospital of Zhengzhou University from January to November 2024.Data collected included general patient information,operative time,postoperative recovery,and follow-up outcomes. Results Among the 13 patients,11 were admitted due to vomiting and 2 due to hematochezia; ages ranged from 1 day to 10 years; 10 were male and 3 female.5 cases were diagnosed preoperatively via gastrointestinal ultrasound suggesting volvulus,while 8 were diagnosed intraoperatively as intestinal malrotation.Intraoperatively,5 patients had concurrent volvulus,2 had strangulated intestinal obstruction,1 had congenital small intestinal atresia,and 1 had congenital diaphragmatic hernia.The mean operative time was 119.46±24.93 minutes; time to initiate feeding postoperatively was 6.00 (4.50,6.50) days; and mean hospital stay was 23.00 ±8.81 days.10 patients tolerated feeding well postoperatively with no vomiting or recurrence of volvulus.2 developed adhesive intestinal obstruction,1 managed conservatively and 1 surgically,with both recovering and being discharged.One patient experienced intermittent vomiting after gradual feeding advancement; conservative treatment was ineffective.Pathology revealed intestinal neuronal dysplasia,and the patient underwent ileostomy at another hospital,with improvement in vomiting. Conclusions The Kareem procedure for pediatric intestinal malrotation restores the intestino-mesenteric anatomy and vascular structures to their normal physiological positions,helping prevent or reduce recurrent volvulus.The short-term outcomes are satisfactory,suggesting the procedure is feasible and safe.It may serve as a new surgical option for pediatric intestinal malrotation,though further large-scale and multicenter studies are needed to evaluate long-term efficacy.
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Memo
收稿日期:2025-1-5。
通讯作者:黄华,Email:hhuang0989@163.com