Efficacy of Laparoscopic Three-point Anterior Gastropexy for Gastric Volvulus in Children

Abstract

Purpose: Gastric volvulus is defined as a rotation of all or part of the stomach by more than 180 degrees along its axis. Surgical repair is required in acute or recurring cases. We analyze the efficacy and safety of our laparoscopic three-point anterior gastropexy (L3pAG).
Methods: A systematic retrospective review of 6 patients (4 boys and 2 girls) who were surgically treated by L3pAG between 2000 and 2013 in our institutes was performed.
Result: The age at surgery ranged from 3 years and 5 months to 11 years and 5 months with an average of 91.8 ± 35.8 months. All the cases were idiopathic volvulus, and they involved developmental disorder in 5, mental retardation in 4, Hirschsprung’s disease in 1, and bronchopulmonary foregut malformation in 1. All of the 5 patients with acute onset successfully received emergent decompression with a nasogastric tube and were followed by elective surgery. The mean operation time for L3pAG was 96.7 minutes. The operative blood loss was minimum, and no severe postoperative complication developed except for mild hyponatremia and fever in 1 patient. The enteral nutrition could be restarted on postoperative day 5.3 on average. No recurrence was observed during an average follow-up period of 46.8 ± 18.8 months (2 years to 6 years and 2 months).
Conclusion: Elective surgery could be performed in patients with acute gastric volvulus after successful treatment with a nasogastric tube. L3pAG might be an effective surgical option in cases of primary volvulus.