Feasibility of Laparoscopic Surgery for Intussusception in Pediatric Patients and Risk of Bowel Resection

Abstract

Intussusception is a common cause of intestinal obstruction in children. While most patients can be treated by enema reduction, about 20% require surgery. We investigated the usefulness and feasibility of laparoscopic surgery and the intraoperative risk of bowel resection. Methods: We retrospectively reviewed pediatric patients who underwent surgery for intussusception from 2010 to 2017. We collected data for age, gender, body weight, associated symptoms, duration of symptoms, white blood cell count, operating time, and postoperative complications. Results: Of 155 patients, 37 (23.8%) underwent surgery due to enema reduction failure in 29 (78.3%), recurrence in 6 (16.3%), a suspicious lead point in 1, and suspicious ischemic change observed on ultrasonography in 1. The mean age was 26.8±18.9 months (range, 3.5~76.7 months), and the mean body weight was 12.9±3.9 kg (range, 5.4~22.2 kg). Laparoscopic surgery was successful in 29 patients (78.4%), and 7 (18.9%) needed bowel resection and anastomosis. The mean operating time was 56.7±32.8 min. A lead point was found in 3 patients in the bowel resection group (p=0.005); in addition, the operating time and hospital stay were longer in this group. There were no intra-or postoperative complications. Conclusion: Laparoscopic surgery was successful in 78.4% of the patients with a short hospital stay and early oral intake. The only predictive factor for bowel resection was the presence of a lead point. Laparoscopic surgery may be an optimal treatment intervention for children with intussusception, except for those who show initial peritonitis.

Laparoscopic approach for managing intussusception in children: Analysis of 65 cases

“…Laparoscopy has been reported to be effective and without major complications for the management of intussusception[ 1 , 2 ], supporting the present study. In the present study, the success rate of laparoscopy was 88%, which is within the 79%-90% range reported by many case series[ 1 - 3 ]. Nevertheless, the use of laparoscopy remains controversial because laparoscopic intussusception reduction has a high rate of conversion to laparotomy, as high as 70% in some reports[ 4 ].…”

“…It was found that the terminal ileum had duplication malformations that were managed with intestinal resection and anastomosis. With the improvement of laparoscopic techniques and instrumentation, we believe that laparoscopic surgery will not be contraindicated by age or intestinal resection because minimally invasive surgery through a small umbilical incision can be achieved even for intestinal resection[ 1 - 3 ].…”

Laparoscopic and open surgery methods in managing surgical intussusceptions: A randomized clinical trial of postoperative complications

“…12 Song et al were unsuccessful in reducing any patient on the operation table by air reduction during laparoscopy. 13 In one patient, after laparoscopy, we noticed perforated appendicitis. This matter may be due to preoperative hydrostatic reduction complications or failure in the diagnostic process.…”

“…In this survey, we did hydrostatic reduction three times (if required) for all patients before surgery to select surgical intussusceptions. [10][11][12][13] We performed another hydrostatic reduction on the operation table under the guidance of laparoscopic exploration. In intra-operative reduction, all attempts were unsuccessful.…”

Indicações e comparação entre as vias alimentares cirúrgicas por ostomias em pacientes que necessitam de dieta enteral

“…O tubo, então, é inserido no jejuno com cuidado de forma em que se garanta espaço suficiente, evitando o refluxo alimentar através do mesmo. A sutura purse string então fixa o tubo garantindo o seu adequado posicionamento (SONG, 2023;SIOW et al, 2017).…”