Outcomes Following Laparoscopic Versus Open Surgery for Pediatric Intussusception: Analysis Using a National Inpatient Database in Japan

Abstract

BackgroundLaparoscopic surgery for pediatric intussusception has recently become more common as an alternative to open surgery. However, the differences in outcomes between laparoscopic and open surgery remain unclear. Thus, this study aimed to compare short-term surgical outcomes and recurrence rates between patients treated with laparoscopic and open surgery for pediatric intussusception. MethodsPatients aged <18 years who underwent laparoscopic (n = 192) and open (n = 416) surgery for intussusception between April 2016 and March 2021 were retrospectively identified using a Japanese nationwide inpatient database. Propensity-score overlap weighting analyses were conducted to compare the outcomes between the laparoscopic and open surgery groups. The outcomes included in-hospital morbidity, reoperation, readmission for intussusception, bowel resection, the diagnosis of Meckel's diverticulum, duration of anesthesia, postoperative length of hospital stay, and total hospitalization costs. ResultsThe laparoscopic surgery group was older, heavier, and had fewer congenital malformations and emergency admissions than the open surgery group did. Overlap weighting analyses showed no significant differences in in-hospital morbidity (odds ratio [95% confidence interval], 0.88 [0.35−2.23]), reoperation (1.88 [0.24−14.9]), readmission for intussusception within 30 days (0.80 [0.12−5.30]) and 1 year (0.90 [0.28−2.93]), bowel resection (0.69 [0.46–1.02]), the diagnosis of Meckel's diverticulum (0.97 [0.50−1.90]), duration of anesthesia (difference, 11 [-1−24] minutes), postoperative length of stay (difference, −1.9 [-4.2−0.4] days), or total hospitalization costs (difference, 612 [ −746−1970] US dollars) between the groups. ConclusionsIn this large nationwide cohort, no significant differences in outcomes were observed between laparoscopic and open surgery. Laparoscopic surgery is an acceptable treatment option for pediatric intussusception. Levels of EvidenceLevel III.