2018 Volume 54 Issue 5 Pages 1065-1070
Purpose: The treatment of giant cystic meconium peritonitis (GCMP) is difficult in the presence of strong inflammatory changes. For determining the optimal treatment, we retrospectively reviewed the treatments in our GCMP case series.
Methods: We reviewed the medical records of six patients with GCMP treated from 2000 to 2015 at our institution. We divided these patients into two groups according to the type of treatment, enterostomy (enterostomy group: EG, n = 4) or drainage (drainage group: DG, n = 2), at the initial surgery.
Results: Six patients were diagnosed as having meconium peritonitis prenatally. The median gestational age was 35.5 weeks (34–38 weeks) in EG and 34 weeks (31 and 37 weeks) in DG. The median birth weight was 2,647 g (2,526–2,777 g) in EG and 2,551 g (2,397 and 2,705 g) in DG. In DG, the operation time was shorter and the amount of bleeding was smaller. On the other hand, the postoperative nutritional start was earlier in EG. Patient 6 underwent surgery three times, but the others did twice. The duration from the first surgery to radical surgery was over 30 days in all patients. The complications were abdominal wall hernia in one patient and anastomotic stenosis in one patient in EG, and liver dysfunction in two patients in DG. The median follow-up period was 37.5 months (16–186 months). Except for the patient with trisomy 21, the other patients have shown normal development.
Conclusion: We obtained a good outcome by performing enterostomy or drainage at the first surgery followed by radical surgery after 30 days. Multistage surgery could be an option in the treatment of GCMP.
