TABLE 5.
Clinical Features and Operative Details of the Gut Malrotation Correction (GMC) Surgery Patients
| Colonic Dysmotility | ||||
| Variable | Total | No | Yes | P Value |
| Study patients (%) | 80 | 55 (69) | 25 (31) | NA |
| Children / Adults | 6 / 74 | 4 / 51 | 2 / 23 | 0.437 |
| Sex (Female : Male) | 3 : 1 | 2.2 : 1 | 7.3 : 1 | 0.05 |
| Race (White / African-American) | 79 / 1 | 54 / 1 | 25 / 0 | 0.5 |
| International patients (%) | 9 (11) | 7 (13) | 2 (8) | 0.257 |
| Hospital to hospital transfer (%) | 11 (14) | 9 (16) | 2 (8) | 0.3 |
| Age at onset of symptoms (mean ± SD, yr) | 22 ± 17 | 21 ± 17 | 25 ± 17 | 0.31 |
| Age at time of diagnosis (mean ± SD, yr) | 29 ± 17 | 27 ± 18 | 32 ± 14 | 0.015 |
| Age at time of surgery (mean ± SD, yr) | 36 ± 14 | 35 ± 14 | 37 ± 13 | 0.58 |
| Time from diagnosis to surgery (median [IQR], yr) | 3 [1–9] | 2 [1–9] | 4 [1–6] | 0.06 |
| Duration of symptoms (mean ± SD, yr) | 14 ± 15 | 14 ± 14 | 12 ± 11 | 0.05 |
| Total parenteral nutrition requirement (%) | 13 (16) | 8 (15) | 5 (20) | 0.5 |
| Recurrent bowel obstruction/volvulus (%) | 23 (29) | 14 (25) | 9 (36) | 0.3 |
| Scores of NIH-PROMIS-GI symptom scales (mean ± SD) | 29 ± 9 | 28 ± 9 | 32 ± 9 | 0.19 |
| Small bowel bacterial overgrowth (%) | 20 (25) | 10 (18) | 10 (40) | 0.04 |
| Prior abdominal surgery | ||||
| Number of patients (%) | 68 (85) | 48 (87) | 20 (80) | 0.2 |
| Number of procedures (mean ± SD) | 2 ± 2 | 2 ± 2 | 3 ± 2 | 0.2 |
| Number of prior Ladd's procedure (%) | 45 (56) | 28 (52) | 17 (68) | 0.2 |
| Elective | 34 (76) | 20 (71) | 14 (82) | 0.147 |
| Open | 25 (56) | 14 (50) | 11 (65) | 0.2 |
| Prior liver transplant | 2 (3) | 2 (4) | 0 (0) | NA |
| Prior bariatric surgery (%) | 3 (4) | 0 (0) | 3 (12) | NA |
| Connective tissue/autoimmune disorders (%) | 16 (20) | 5 (9) | 11 (44) | 0.0005 |
| Total surgical procedures (%) | ||||
| Completion of upper midgut rotation | 79 (99)∗ | 54 (98) | 25 (100) | 0.373 |
| Foregut reconstruction | 6 (8) | 2 (4) | 4 (16) | 0.0314 |
| Duodenoplasty | 4 (5) | 2 (4) | 2 (8) | 0.228 |
| Reduction of jejunal intussusception | 2 (3) | 2 (4) | 0 (0) | NA |
| Colon resection | 52 (65) | 31 (56) | 21 (84) | 0.007 |
| Pyloroplasty | 3 (4) | 0 (0) | 3 (12) | 0.002 |
| Diverting stoma | 4 (5) | 0 (0) | 4 (16) | 0.002 |
| Operative time (mean ± SD, hour) | 6.5 ± 2.1 | 6.5 ± 2.1 | 6.3 ± 2.3 | 0.5 |
| Operative blood loss (mean ± SD, ml) | 75 ± 41 | 75 ± 41 | 75 ± 43 | 0.9 |
| Length of hospital stay (mean ± SD, d) | 13 ± 5 | 13 ± 6 | 12 ± 3 | 0.3 |
| Clavien-Dindo complication grade (%) | 7 (9) | 5 (9) | 2 (8) | 0.44 |
| Grade I-II | 4 (5) | 3 (5) | 1 (4) | |
| Grade IIIa-IVa | 3 (4) | 2 (4) | 1 (4) | |
| Readmission (%)† | 6 (8) | 3 (5) | 3 (12) | 0.0019 |
| Total loaded cost (mean ± SD, $)‡ | 64 ± 22 | 63 ± 21 | 70 ± 23 | 0.6 |
| Overall survival (%) | 100 | 100 | 100 | 1.0 |
| Follow-up (mean ± SD, mo) | 37 ± 23 | 37 ± 21 | 35 ± 28 | 0.7 |
NA indicates non-applicable.
∗
The liberated duodenum of the remaining patient was maintained and fixed on the left side (See Supplementary Figure 8).
†
Within first postoperative year.
‡
In thousands.