Laparoscopic versus open management of adult intussusception

Siow, Sze Li; Goo, Zhen Qiang; Mahendran, Hans Alexander; Wong, Chee Ming

doi:10.1007/s00464-019-07220-z

Cited by 19 publications

(15 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Laparoscopic surgery has been shown to be safe and feasible, and the laparoscopic approach includes the benefits of minimally invasive surgery. 18 A previous report also showed that laparoscopy is safe and effective in the treatment of paediatric intussusception. 19 In the current study, 115 patients (115/139, 82.7%) underwent open surgery, and laparoscopy-assisted surgery was performed in 24 (24/139, 17.3%) patients.…”

Section: Discussionmentioning

confidence: 96%

<p>Most Adult Intussusceptions are Caused by Tumors: A Single-Centre Analysis</p>

Su¹,

He²,

Zhou³

et al. 2020

CMAR

View full text Add to dashboard Cite

Background: Adult intussusception is less common than paediatric intussusception. The aim of this study was to explore the clinical presentation, aetiology, diagnosis and treatment of adult intussusception. Methods: Adults (>18 years) with intussusception treated by surgical or conservative measures were included from January 2005 to January 2018, and the manifestation, types, diagnosis and treatment of adult intussusception in our centre were reviewed. Results: A total of 150 patients with adult intussusception were included in this study. The clinical manifestations included 111 cases (74%) of abdominal pain, 38 cases (25.3%) of bloody stool, 37 cases (24.7%) of bowel obstructions, 33 cases (22%) of abdominal distension, 29 cases (19.3%) of nausea and vomiting, 19 cases (12.7%) of an abdominal mass, and 12 cases (8.0%) of diarrhoea. The types of intussusception were classified into 36 cases (24%) of enteric intussusception, 87 cases (58%) of intestine-colon intussusception and 27 cases (18%) of colonic intussusception. Surgical intervention was applied in 139 cases (92.7%), including 115 patients who underwent open surgery, and laparoscopy-assisted surgery was performed in 24 patients. The main pathogenesis of intussusception was malignant tumors in 51 cases (36.7%) and benign tumors and polyps in 49 cases (35.3%). Conclusion: Malignant and benign tumors are the main causes of adult intussusception. Abdominal CT is the preferred evaluation method for the preoperative diagnosis of this condition. The choice of surgical procedure depends on the location and type of intussusception.

show abstract

Section: Discussionmentioning

confidence: 96%

<p>Most Adult Intussusceptions are Caused by Tumors: A Single-Centre Analysis</p>

Su¹,

He²,

Zhou³

et al. 2020

CMAR

View full text Add to dashboard Cite

show abstract

“…Most patients could be successfully managed by non-surgical reduction, while a few patients who failed in radiological reduction still require operative reduction [4,5]. Given the shorter length of hospital stay and equivalent complication rates compared with open surgery, laparoscopic reduction is demonstrated to be a safe and feasible approach and has been recommended as the prime option [6][7][8][9][10][11]. Every now and then, conversion was required in a laparoscopic approach.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for conversion to open approach during laparoscopic reduction of intussusception in children who failed fluoroscopy-guided pneumatic enema reduction: experience from a single‐center experience in 94 consecutive patients- an original article.

Sun

Liu

et al. 2022

Preprint

View full text Add to dashboard Cite

Objective To summarize our experience in laparoscopic treatment of intussusception in children who failed fluoroscopy-guided pneumatic enema reduction, and to identify the independent risk factors that may relate to conversion to open approach.Methods A retrospective analysis of patients with intussusception who failed pneumatic enema reduction was performed from August 2014 to March 2021. Patients who completed laparoscopic intussusception reduction were compared with those who converted to open approach regarding demographic (age, gender), history (previous abdominal surgery history, number (No.) of intussusception before), clinical manifestations (preoperative pneumatic enema attempts, abdominal pain, irritable crying, emesis, bloody stool, abdominal mass, fever, diarrhea, duration of symptoms, body mass index, American Society of Anesthesiologists fitness grade), work-up (Leukocyte counts), and intra-operative findings (anatomic type of intussusception, number (No.) of intussusceptions, length of intussusception, outcome (operative time, complications, postoperative hospital stay). Statistic analyze was performed using univariate and Logistic regression analysis. Results Univariate analysis showed that small bowel intussusception was associated with conversion to laparotomy (p < 0.05). Logistic regression analysis indicated that bloody stool (odds ratio (OR)26.071; 95% confidence interval (CI)2.341,290.33; p < 0.01) and small bowel intussusception (odds ratio (OR)39.194; 95% confidence interval (CI)3.562,431.281; p < 0.01) may be independent risk factors related to the conversion from laparoscopic intussusception to open procedure (p < 0.01).Conclusion Bloody stool and small bowel intussusception may be the independent risk factors associated with the conversion to laparotomy in laparoscopic treatment for intussusception in children who failed fluoroscopy-guided pneumatic enema reduction.

show abstract

“…Laparoscopic surgical reduction for adult idiopathic intussusception was useful and effective. The earliest description of laparoscopic-assisted resection of intussusception due to Meckel's diverticulum was reported in 1993 [14]. Since then, the number of reports of laparoscopic approach for intussusception had gradually increased.…”

Section: Discussionmentioning

confidence: 99%

Successful laparoscopic approach for idiopathic adult colo-colonic intussusception: a case report

et al. 2020

View full text Add to dashboard Cite

Background Adult intussusception is recognized as an abdominal emergency. More than 90% of adult patients with intussusception have distinct causes that are related to benign or malignant tumors. In contrast, idiopathic intussusceptions, which are observed in children, are rare conditions in adult. Especially, colo-colonic idiopathic intussusceptions are rare among them. Surgery is traditionally considered the primary treatment option. Recently, laparoscopic surgery has been reported to be safe and feasible. However, laparoscopic surgical reduction, which is a common procedure in pediatric surgery, is not common in adult intussusception. Case presentation We report a 34-year-old man who presented with sudden abdominal pain. Computed tomography revealed the target sign in the transverse colon. There was no evidence of bowel obstruction, bowel wall edema, or tumor. We diagnosed idiopathic intussusception and selected laparoscopic procedure because of the strong abdominal pain experienced by the patient. There were no signs of perforation, bowel wall ischemia, or tumor in abdominal cavity. We confirmed idiopathic colo-colonic anterograde intussusception. Laparoscopic surgical reduction was achieved by a combination of delicate direct pressure on the anal side of the transverse colon and gentle pulling on the oral side. The patient’s postoperative course was uneventful. Conclusions We achieved successful surgical reduction laparoscopically because of an accurate preoperative diagnosis based on characteristic computed tomography features and appropriate surgical technique. Laparoscopic procedure and surgical reduction is considered to be an effective treatment strategy for adult idiopathic intussusceptions with severe symptoms.

show abstract

Laparoscopic versus open management of adult intussusception

Cited by 19 publications

References 17 publications

<p>Most Adult Intussusceptions are Caused by Tumors: A Single-Centre Analysis</p>

<p>Most Adult Intussusceptions are Caused by Tumors: A Single-Centre Analysis</p>

Risk factors for conversion to open approach during laparoscopic reduction of intussusception in children who failed fluoroscopy-guided pneumatic enema reduction: experience from a single‐center experience in 94 consecutive patients- an original article.

Successful laparoscopic approach for idiopathic adult colo-colonic intussusception: a case report

Contact Info

Product

Resources

About