Laparoscopic versus open reduction of idiopathic intussusception in children: an updated institutional experience

Jian Zhao,Wei Jue Xu,Deyu Li,Jun Sun

doi:10.1186/s12887-022-03112-9

Jian Zhao, Wei Jue Xu + Show 2 more

Open Access

https://doi.org/10.1186/s12887-022-03112-9

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Abstract

BackgroundIn the reduction of intussusception, due to the lack of randomized, controlled, and prospective clinical trials to confirm the superiority of the laparoscopic approach over open surgery, more evidence was needed. This study aimed to compare the results of laparoscopy and open reduction of idiopathic intussusception in children as well as to illustrate some skills for the reduction of intussusception laparoscopically.MethodsA retrospective review was performed to evaluate outcomes for patients with idiopathic intussusception who were treated laparoscopically (LAP group) from January 2015 to December 2019 and to compare the outcomes with laparotomy (OPEN group) during the same period.ResultsDuring the period studied, there were 162 patients treated surgically for intussusception: 62 LAP and 100 OPEN. No statistical differences were found in demographic data, clinical symptoms and signs, duration of symptoms, location and types of intussusception between the two groups. Conversion to open procedure was required for 11 patients in the LAP group. The operation time and time to oral intake were shorter in the LAP group while the difference was not significant. If the 11 conversion cases were excluded, the operation time and time to oral intake were significantly shorter (P < 0.05) in the LAP group. The length of stay was significantly shorter in the LAP group (P < 0.05). Intraoperative and postoperative complication rates between the two groups were comparable (P = 1.0).ConclusionLaparoscopy was safe and effective in the treatment of pediatric idiopathic intussusceptions. Pediatric surgeons with sophisticated minimally invasive skills should choose laparoscopy as the first choice in the treatment of idiopathic intussusceptions.

Highlights

Acute intussusception was one of the most common causes of acute abdominal pain in children, and it was the most frequent cause of intestinal obstruction in children aged 3 months to 5 years
A large right-sided transverse incision was needed for manual reduction
This study aims to compare the results of laparoscopy and open reduction of idiopathic intussusception in children as well as to elaborate some skills for the management of intussusception laparoscopically

Summary

Introduction

Acute intussusception was one of the most common causes of acute abdominal pain in children, and it was the most frequent cause of intestinal obstruction in children aged 3 months to 5 years. The vast majority (nearly 95%) of intussusception lacked a definite pathologic lead point and were classified as idiopathic intussusceptions [1]. The image-guided pneumatic reduction was the first-line management in our institution, and the success rate was 91.9%. With the advancement of minimally invasive surgery in children, the laparoscopic approach was increasingly used in the management of intussusception [3,4,5,6]. In the reduction of intussusception, due to the lack of randomized, controlled, and prospective clinical trials to confirm the superiority of the laparoscopic approach over open surgery, more evidence was needed. This study aimed to compare the results of laparoscopy and open reduction of idiopathic intussusception in children as well as to illustrate some skills for the reduction of intussusception laparoscopically

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