Published online Jan 21, 2022. doi: 10.12998/wjcc.v10.i3.830
First decision: November 6, 2021
Revised: November 19, 2021
Accepted: December 25, 2021
Article in press: December 25, 2021
Published online: January 21, 2022
Processing time: 166 Days and 9.8 Hours
Intussusception can be managed by pneumatic reduction, ultrasound-guided hydrostatic reduction, open or laparoscopic surgery, but laparoscopy in such cases remains controversial.
To explore the clinical characteristics, effectiveness, and complications of surgical reduction for intussusception using laparoscopy in children.
This study was a retrospective case series of pediatric patients with intussusception who underwent surgical reduction by laparoscopy from May 2011 to April 2016 at Taizhou Hospital of Zhejiang Province. Clinical characteristics (operation time, intraoperative blood loss, conversion rate of laparotomy, reasons for conversion, postoperative hospital stay, and adverse events) were described.
The 65 patients included 45 boys and 20 girls. The average age was 2.3 years (27.5 ± 24.5 mo). Of the 65 patients, 61 underwent surgical reduction by laparoscopy after a failed enema reduction of intussusception, and four underwent the procedure directly. All patients were treated successfully and 57 (87.7%) patients underwent successful laparoscopic surgery, two of which had a spontaneous reduction. Among the remaining cases, one was converted to open surgery via right upper quadrant incision, and seven required enlarged umbilical incisions. Intestinal resection was performed in 5 patients because of abnormal bowel lesions. There were no complications (intestinal perforations, wound infections, or intestinal adhesions) during the follow-up of 3 years to 8 years. Two patients experienced a recurrence of intussusception; one was resolved with pneumatic reduction, and the other underwent a second laparoscopic surgery.
Laparoscopic approach for pediatric intussusception is feasible and safe. Bowel resection if required can be performed by extending umbilical incision without the conventional laparotomy.
Core Tip: This study aimed to explore the clinical characteristics, effectiveness, and complications of surgical reduction for intussusception using laparoscopy in children. Laparoscopic intussusception reduction can be beneficial and without significant complications if well indicated, and if an extension of the umbilical incision is used if needed. Laparoscopic assistance can also yield good treatment outcomes in some complicated cases requiring intestinal resection.