34 A SINGLE CENTRE EXPERIENCE OF SINGLE PORT SURGERY (SPS) IN CHILDREN
Kathryn Ford1, Hannah Cornwall2, Snigdha Reddy1, E Tough2, Kokila Lakhoo1, Hugh Grant1
1Oxford University Hospital, Oxford, United Kingdom. 2Oxford University, Oxford, United Kingdom

Abstract

AIM: Describe a single centre’s experience of paediatric single port surgery (SPS).

METHODS: Review of a prospective database of SPS procedures from Dec 2009 – Aug 2017. Data recorded included: patient demographics, diagnosis, length of stay, conversion, complications and readmission.

MAIN RESULTS: 318 SPS cases (n=213 (67%) female) were conducted over the nine-year period (Table 1). 13/318 (4%) cases were converted (n=12 open, n=1 additional ports). 34/318 (11%) complications occurred, the four most common being: wound infection (n=11), further surgery (laparotomy) (n=8), adhesions (n=7) and intra-abdominal collection (n=6). Complications and readmission were more common following appendicectomy cf. all other procedures combined (n=27, p<0.001 Fisher’s exact and n=8, p 0.0023 Fisher’s exact, respectively).

CONCLUSIONS: SPS has a wide range of indications with a low complication and conversion rate. Differences identified in the appendicectomy cohort reflect the underlying septic process.

TABLE 1:

Procedure

Number of cases

Age*

(yrs)

LOS* (days)

Complication rate

(% per procedure)

Readmission

Appendicectomy

103

12.2

(4.6-15.9)

3

(0-24)

27/103

(26%)

8/103

(7.7%)

Meckel’s

6

10.0

(2.0-11.1)

3.5

(3-6)

0

0

Ovarian pathology

9*

14.5

(7.6-15.3)

2

(1-3)

0

0

Oopherectomy for cryotherapy

120

10.0

(1.3-17.8)

1

(0-7)

1/120

(0.8%)

0

Ovary biopsy for cryotherapy

6

15.6

(7.9-17.3)

2

(1-2)

0

0

Male urological procedure

12

2.3

(1.7-14.9)

4

 (0-4)

1/12

(8%)

0

Fundoplication

8

10.7

(5.4-14.4)

4

(2-5)

0

1/8

(12%)

Fundoplication & PEG

8

4.9

(1.3-12.2)

5.5

(3-18)

0

0

Assisted PEG

10

3.0

(1.1-13.8)

4

(2-10)

0

0

Cholecystectomy

2

14.9

(14.1-15.7)

2

(0-4)

0

0

Intussusception

2

7.4

(1.5-13.2)

1

 (1-1)

2

(100%)

0

Mesenteric cyst

1

12.6

1

0

0

ACE

11

9.8

(5.6-15.6)

3

 (1-5)

2/11

(18%)

0

Right hemicolectomy

6

13.5

(11.0-15.7)

8

(5-24)

1

(17%)

0

Look see

15

7.1

(0.3-13.9)

2

(0-36)

0

1/15

(7%)

TOTAL

319

-

-

34 (11%)

10 (3%)

* median (range)


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