Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 21, 2022; 10(3): 830-839
Published online Jan 21, 2022. doi: 10.12998/wjcc.v10.i3.830
Laparoscopic approach for managing intussusception in children: Analysis of 65 cases
Sheng-Miao Li, Xiao-Ying Wu, Chun-Fen Luo, Lin-Jun Yu
Sheng-Miao Li, Xiao-Ying Wu, Chun-Fen Luo, Lin-Jun Yu, Department Pediatric Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou 317000, Zhejiang Province, China
Author contributions: Li SM conceived and coordinated the study, designed, performed and analyzed the experiments, wrote the paper; Wu XY, Luo CF and Yu LJ carried out the data collection, data analysis, and revised the paper; all authors reviewed the results and approved the final version of the manuscript.
Institutional review board statement: The study was approved by the ethics committee of Taizhou Hospital.
Informed consent statement: The requirement for informed consent was waived by the committee because of the retrospective nature of the study.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lin-Jun Yu, MS, Doctor, Department Pediatric Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, No. 150 Ximen Street, Taizhou 317000, Zhejiang Province, China. wannanyixue@163.com
Peer-review started: August 2, 2021
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
Abstract
BACKGROUND

Intussusception can be managed by pneumatic reduction, ultrasound-guided hydrostatic reduction, open or laparoscopic surgery, but laparoscopy in such cases remains controversial.

AIM

To explore the clinical characteristics, effectiveness, and complications of surgical reduction for intussusception using laparoscopy in children.

METHODS

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.

RESULTS

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.

CONCLUSION

Laparoscopic approach for pediatric intussusception is feasible and safe. Bowel resection if required can be performed by extending umbilical incision without the conventional laparotomy.

Keywords: Laparoscopy, Intussusception, Air reduction, Benefits, Complications

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.