Laparoscopic vs open surgical approach for intussusception requiring operative intervention
Section snippets
Methods
A retrospective study of 42 patients surgically treated for intussusception since 1994 was performed. Data were obtained from our hospital and satellite hospitals covered by our pediatric surgeons. Institutional Review Board approval was obtained from all participating hospitals. Intussusception was diagnosed by either contrast enema or ultrasonography. All patients were referred to our service only after failing radiological reduction. Choice of laparoscopic (LAP) or open (OPN) approach was
Results
The 41 patients who underwent surgical reduction for small bowel intussusception ranged from 1 month to 7 years old. Sixteen patients underwent laparoscopic reduction; 2 (12.5%) of which required conversion to an open procedure. The remaining 25 were handled via the open approach. Based on surgical procedure, 2 groups were established for analysis. Patients treated initially with laparoscopy were placed in the group LAP (n = 16). Patients who underwent laparotomy were placed in the group OPN (n
Discussion
The management of intussusception has not been standardized. Initial diagnosis is usually performed by contrast enema, but air enema and ultrasound are also effective [9], [10], [11]. Nonsurgical attempts at reduction should be the first line of therapy for any intussusception patient unless there are obvious signs of bowel necrosis or perforation. Reduction is considered complete when patency of the ileocecal valve can be demonstrated by contrast material or ultrasound. Unsuccessful
References (17)
- et al.
Results of air pressure enema reduction of intussusception: 6396 cases in 13 years
J. Pediatr. Surg.
(1986) - et al.
Ultrasound-guided water enema: an alternative method to nonoperative treatment for childhood intussusception
J. Pediatr. Surg.
(1994) - et al.
Laparoscopy in the treatment of intussusception in children
J. Pediatr. Surg.
(1998) Experience with laparoscopy in the treatment of intussusception
J. Pediatr. Surg.
(1997)- et al.
Review of pneumatic reduction of intussusception: evolution not revolution
J. Pediatr. Surg.
(1994) - et al.
Hydrostatic reduction ileocolic intussusception: a second attempt in the operating room with general anesthesia
J. Pediatr.
(1989) - et al.
Intussusception: 354 cases in 10 years
J. Pediatr. Surg.
(1971) - et al.
Idiopathic intussusception: the role of laparoscopy
J. Pediatr. Surg.
(1999)
Cited by (64)
Management of intussusception in children: A systematic review
2021, Journal of Pediatric SurgeryThe incidence of negative intraoperative findings after unsuccessful hydrostatic reduction of ileocolic intussusception in children: A retrospective analysis
2019, Journal of Pediatric SurgeryCitation Excerpt :Literature related to operative findings after unsuccessful hydrostatic reduction of an ileocolic intussusception is scarce. Kia et al. mentioned that approximately 10% of all intussusceptions failing radiologic reduction, will have spontaneously reduced by the time of surgery [10]. This percentage is, however, based on the results of other studies conducted more than 25 years ago (1971–1989).
Perforated gangrenous ileo-colic intussusception in a 9 month old Nigerian infant presenting at a private hospital: A case report
2019, International Journal of Surgery Case ReportsIntussusception in infancy and childhood: Radiological and surgical management
2015, Archives de PediatrieAcute intussusception in infants and children - Answers
2015, Journal de Pediatrie et de PuericultureBulletin Infovac
2015, Journal de Pediatrie et de Puericulture