Ileopexy in open reduction of ileocolic intussusception in pediatrics: its role on recurrence

Abstract

Background Intussusception is the main reason of intestinal obstruction in pediatrics. Hydrostatic reduction (HR) is the cornerstone in its treatment. However, surgical treatment is indicated in case of failure of HR. Fixation of terminal ileum (ileopexy) has been used to reduce or even prevent recurrence of intussusception, but its outcome has not been well studied. Aim The aim was to investigate the effect of fixation of terminal ileum on recurrence rate after surgical reduction of intussusception in pediatric age group. Patients and methods A total of 80 children scheduled for surgical reduction of intussusception were included and randomly assigned to fixation of terminal ileum (group A; n=40) or no fixation (group B; n=40). All were assessed clinically, and laboratory investigations were done. Patient’s demographics and surgical outcome were documented and compared between both groups. Results Both groups were comparable regarding demographic data, clinical presentation, duration of symptoms before admission, surgical indication, and duration of hospital stay. In addition, the recurrence rate was nonsignificantly reduced in group A when compared with group B (5.0 vs. 15.0%, respectively). In addition, HR was successful in one and failed in the other recurrent case in group A (50.0% of success) compared with only one (16.7%) of six in group B. Conclusion Fixation of terminal ileum during surgical reduction of intussusception is safe, feasible, and simple technique. It results in reduction of the recurrence rate. However, the difference was statistically nonsignificant.