Laparoscopic versus open reduction of intussusception in children: a retrospective review and meta-analysis.

Abstract

Intestinal intussusception is a frequent cause of bowel obstruction in children. Initial treatment involves pneumatic reduction. If this fails, operative reduction is indicated. There is controversy regarding use of the laparoscopic (LAP) versus the conventional open approach. We performed a retrospective review of all children with intussusception who required operative reduction at our institution over a 12-year time period. We also performed a meta-analysis to combine our data with the published literature. We identified 28 patients requiring operative intervention for reduction of intussusception between January 2000 and April 2012. Five patients underwent LAP reduction, and 23 patients underwent open reduction. Operative times were not statistically different. The rate of overall complications was not statistically different, with 1 of 5 (20%) and 7 of 23 (30%) having complications in the LAP and open groups, respectively. Mean length of stay was 3.8±2.1 days in both the LAP and open groups, with no significant difference. Our meta-analysis identified five retrospective studies comparing LAP and open techniques for reduction of intussusception. We did not find a significant difference between groups with respect to operative time, overall complication rates, or re-operation rates. However, the length of hospital stay was significantly longer in the open group. LAP reduction of intussusception is a safe and feasible alternative to the open approach. Length of stay may be shorter in the LAP group.