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Laparoscopy in pediatric surgery: implementation in Canada and supporting evidence

Laparoscopy in pediatric surgery: implementation in Canada and supporting evidence
Laparoscopy in pediatric surgery: implementation in Canada and supporting evidence
Background/purpose: The purpose of this study was to assess the diffusion of laparoscopy usage in Canadian pediatric centers and the relationship between uptake of laparoscopic surgery and the level of evidence supporting its use.

Methods: National data on four pediatric laparoscopic operations (appendectomy, pyloromyotomy, cholecystectomy, splenectomy) were analyzed using the Canadian Institute for Health Information Discharge Database (2002–2013). The highest level of evidence to support the use of each procedure was identified from Cochrane, Embase, and Pubmed databases. Chi-square test for trend was used to determine significance and time to plateau.

Results: There were 28,843 operations (open: 12,048; laparoscopic: 16,795). Use of laparoscopic procedures increased over time (p < 0.0001). A plateau was reached for cholecystectomy (2006), splenectomy (2007), and appendectomy (2012), but not for pyloromyotomy. Laparoscopic pyloromyotomy in 2013 remains less diffused than the other procedures (p < 0.0001). Laparoscopic appendectomy and pyloromyotomy are supported by level-1a evidence in children, whereas cholecystectomy and splenectomy are supported by level-1a evidence in adults but level-3 in children.

Conclusions: In Canada, it has taken a long time to reach high-level implementation of laparoscopic surgery in children. Laparoscopic cholecystectomy first reached plateau, whereas laparoscopic pyloromyotomy continues to increase but remains low despite high level of evidence in support of its usage compared to open surgery.
laparoscopy, minimally invasive surgery, children, pediatric surgery, surgery, appendicitis, cholecystectomy, pyloromyotomy, splenectomy
0022-3468
1-6
Sattarova, Victoria
bb3e3531-3b8a-4d46-aff1-1b954fbd6c7e
Eaton, Simon
e14103c2-c06a-45e6-87fe-2358a3371283
Hall, Nigel J.
6919e8af-3890-42c1-98a7-c110791957cf
Lapidus-Krol, Eveline
35c734f4-de58-4047-8f4d-348cea5b5b39
Zani, Augusto
219e67b0-b2c1-49e0-af38-a179993eb83d
Pierro, Agostino
74bd6b37-4305-47fd-847d-c19a08718997
Sattarova, Victoria
bb3e3531-3b8a-4d46-aff1-1b954fbd6c7e
Eaton, Simon
e14103c2-c06a-45e6-87fe-2358a3371283
Hall, Nigel J.
6919e8af-3890-42c1-98a7-c110791957cf
Lapidus-Krol, Eveline
35c734f4-de58-4047-8f4d-348cea5b5b39
Zani, Augusto
219e67b0-b2c1-49e0-af38-a179993eb83d
Pierro, Agostino
74bd6b37-4305-47fd-847d-c19a08718997

Sattarova, Victoria, Eaton, Simon, Hall, Nigel J., Lapidus-Krol, Eveline, Zani, Augusto and Pierro, Agostino (2016) Laparoscopy in pediatric surgery: implementation in Canada and supporting evidence. Journal of Pediatric Surgery, 1-6. (doi:10.1016/j.jpedsurg.2016.02.030).

Record type: Article

Abstract

Background/purpose: The purpose of this study was to assess the diffusion of laparoscopy usage in Canadian pediatric centers and the relationship between uptake of laparoscopic surgery and the level of evidence supporting its use.

Methods: National data on four pediatric laparoscopic operations (appendectomy, pyloromyotomy, cholecystectomy, splenectomy) were analyzed using the Canadian Institute for Health Information Discharge Database (2002–2013). The highest level of evidence to support the use of each procedure was identified from Cochrane, Embase, and Pubmed databases. Chi-square test for trend was used to determine significance and time to plateau.

Results: There were 28,843 operations (open: 12,048; laparoscopic: 16,795). Use of laparoscopic procedures increased over time (p < 0.0001). A plateau was reached for cholecystectomy (2006), splenectomy (2007), and appendectomy (2012), but not for pyloromyotomy. Laparoscopic pyloromyotomy in 2013 remains less diffused than the other procedures (p < 0.0001). Laparoscopic appendectomy and pyloromyotomy are supported by level-1a evidence in children, whereas cholecystectomy and splenectomy are supported by level-1a evidence in adults but level-3 in children.

Conclusions: In Canada, it has taken a long time to reach high-level implementation of laparoscopic surgery in children. Laparoscopic cholecystectomy first reached plateau, whereas laparoscopic pyloromyotomy continues to increase but remains low despite high level of evidence in support of its usage compared to open surgery.

Full text not available from this repository.

More information

Accepted/In Press date: 7 February 2016
e-pub ahead of print date: 13 February 2016
Keywords: laparoscopy, minimally invasive surgery, children, pediatric surgery, surgery, appendicitis, cholecystectomy, pyloromyotomy, splenectomy
Organisations: Human Development & Health

Identifiers

Local EPrints ID: 388769
URI: http://eprints.soton.ac.uk/id/eprint/388769
ISSN: 0022-3468
PURE UUID: 4270430c-7033-43c6-92d2-350a272bd500
ORCID for Nigel J. Hall: ORCID iD orcid.org/0000-0001-8570-9374

Catalogue record

Date deposited: 02 Mar 2016 16:51
Last modified: 07 Oct 2020 01:59

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