What is the role of laparoscopic surgery in intussusception?

Houben, Christoph H.; Feng, Xiangnan; Tang, Sheung-Ho; Chan, Enoch; Lee, Kim Hung

doi:10.1111/ans.13435

Cited by 14 publications

(13 citation statements)

References 16 publications

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“…Similar results have been reported in recent studies. 3,[16][17][18][19] The patients in this study underwent reduction 1.97 times (mean) before surgery, and a lead point was found in 8.1% of the patients. Wei et al reported a 13% conversion rate from laparoscopic procedure to laparotomy, which was more common in cases with a long intussusception.…”

Section: Discussionmentioning

confidence: 78%

“…Only pathologic lead point was a risk factor for bowel resection in this study, which is consistent with the findings in recent reports. 8,18 Overall, we believe that laparoscopic surgery is worth attempting in patients who have had symptoms for more than 48 h and who do not show peritonitis.…”

Section: Discussionmentioning

confidence: 98%

“…MIS is advantageous for patients who show spontaneous intussusception reduction after a failed enema reduction. Approximately 10~13% of such cases were found after general anesthesia; 17,18,24,25 the associated smooth muscle relaxation may be a possible cause. 17 In this study, we also observed 10.8% cases of spontaneous reduction.…”

Section: Discussionmentioning

confidence: 99%

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

Song

Nam

2018

J Minim Invasive Surg

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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.

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 98%

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

Song

Nam

2018

J Minim Invasive Surg

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“…A recent study by Houben et al reported a high conversion rate (46%) to OS. 22 However, in successful cases, fewer hospitalization days have been reported. In that study, the reason for converting LS to OS was reported as rigid non-manipulative intussusception in seven cases, small abdominal cavity volume for maneuvering and manipulation in four cases, and in two cases, the impossibility of evaluating tactile response with intussusception.…”

Section: Discussionmentioning

confidence: 99%

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

Jamshidi

Rahimi

Gilani

2021

Asian J Endoscop Surgery

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Purpose: To compare postoperative complications of laparoscopic surgery (LS) with open surgery (OS) in surgical intussusception patients.Methods: From March 2015 to February 2018, infants between 6 to 24 months old had the clinical and sono-graphical signs of intussusception enrolled in this double-blind, randomized clinical trial. We divided surgical intussusception patients into two groups. In the LS group, we evaluated patients by direct laparoscopic observation, on-table hydrostatic enema, and mechanical reduction of intussusception. In the OS group, we performed the conventional technique. These patients were followed for 2 years after procedures for comparison of postoperative complications between the two groups.Results: We had 52 patients who needed surgical exploration (26 in each group). There were four (15%) and seven (27%) patients with self-reduced intussusception in LS and OS groups, respectively. The conversion rate was 31% (eight cases). Five cases (19%) in the LS group and four cases (15%) in the OS group needed bowel resections. Operating time was longer in the LS group (P ≤ 0.006), and the postoperative complication rate was higher in the OS group (P ≤ 0.021). Discussion: Laparoscopy is a screening tool to determine the need for OS in surgical intussusception patients. Laparoscopy reduces the incidence of OS and its complications.

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“…This success rate of laparoscopy is comparable to other recent studies with good results. 4,7 Laparoscopic treatment of intussusception in children is technically feasible with successful outcomes if the patient shows no signs of peritonitis or severely distended abdomen. Although the pathologic lead point can make the reduction impossible, the need for bowel resection with conversion to open surgery can be decided according to the presence of a lead point or the failure of reduction after a laparoscopic trial of reduction of intussusceptum.…”

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confidence: 99%

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

Chang

2018

J Minim Invasive Surg

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What is the role of laparoscopic surgery in intussusception?

Abstract: Laparoscopic intervention is meaningful in approximately 50% of children requiring a surgical reduction.

Cited by 14 publications

References 16 publications

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

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

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

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

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