Pediatric surgery international · 2026
Prophylactic appendectomy during Ladd's procedure: a multicenter survey of institutional approaches and their rationales in Japan.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Hanaki Shojiro, Goto Yudai, Yada Keigo, Ohkura Takahiro, Sanmoto Yohei, Kobayashi Tamotsu, Kojima Masato, Goshima Tsubasa, Shinohara Shota, Zenitani Shigetake, Takami Shohei, Takezoe Toshiko, Hashizume Naoki, Yano Keisuke, Hattori Kengo
Аннотация
PURPOSE: To describe institutional approaches to prophylactic appendectomy during Ladd's procedure in Japan, including rationales and prespecified exceptions.
METHODS: We conducted a cross-sectional questionnaire survey through the Japanese Society of Pediatric Surgeons Under-45 Working Group. Member institutions reported their usual institutional approach in a standardized index scenario of emergency Ladd's procedure for midgut volvulus in a stable term neonate without intestinal necrosis or perforation. Responses were analyzed descriptively.
RESULTS: Forty-six of 50 invited institutions responded; 45 with a unified institutional approach were analyzed. In the index scenario, 22 institutions (48.9%) reported routinely performing prophylactic appendectomy and 23 (51.1%) reported not performing it. Performance institutions most commonly cited avoidance of future diagnostic confusion (72.7%) and prevention of future appendicitis (68.2%), whereas non-performance institutions emphasized confidence in contemporary imaging (60.9%) and avoidance of unnecessary procedures or complications (47.8%). Among performance institutions, omission was mainly reported in the presence of intestinal necrosis, perforation, or very or extremely low birthweight; deviations from non-performance were rare.
CONCLUSION: Japanese institutions show highly standardized yet divergent approaches to prophylactic appendectomy during Ladd's procedure. These findings clarify how diagnostic, operative, and future reconstructive considerations are balanced and provide a practical framework for protocol review and outcome-focused studies.
METHODS: We conducted a cross-sectional questionnaire survey through the Japanese Society of Pediatric Surgeons Under-45 Working Group. Member institutions reported their usual institutional approach in a standardized index scenario of emergency Ladd's procedure for midgut volvulus in a stable term neonate without intestinal necrosis or perforation. Responses were analyzed descriptively.
RESULTS: Forty-six of 50 invited institutions responded; 45 with a unified institutional approach were analyzed. In the index scenario, 22 institutions (48.9%) reported routinely performing prophylactic appendectomy and 23 (51.1%) reported not performing it. Performance institutions most commonly cited avoidance of future diagnostic confusion (72.7%) and prevention of future appendicitis (68.2%), whereas non-performance institutions emphasized confidence in contemporary imaging (60.9%) and avoidance of unnecessary procedures or complications (47.8%). Among performance institutions, omission was mainly reported in the presence of intestinal necrosis, perforation, or very or extremely low birthweight; deviations from non-performance were rare.
CONCLUSION: Japanese institutions show highly standardized yet divergent approaches to prophylactic appendectomy during Ladd's procedure. These findings clarify how diagnostic, operative, and future reconstructive considerations are balanced and provide a practical framework for protocol review and outcome-focused studies.