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Management of adhesive bowel obstruction in children is changed by laparoscopy
1Department of Pediatric Surgery, Wilhelmina Children's University Hospital, Post Office Box 85090, 3508AB Utrecht, The Netherlands.
Background:
With new advances in diagnostic and therapeutic tools, the early management of adhesive bowel obstruction has become feasible.
Methods:
In a retrospective study, 20 children with adhesive bowel obstruction were investigated to assess the possible advantages of the laparoscopic approach.
Results:
Laparoscopy was performed in nine children. Six of them were managed laparoscopically. Recovery was uneventful. In two children, extensive adhesions warranted elective conversion. The single complication occurred in a child with obstruction of the colon due to perforation caused by a small instrument. Eleven children underwent primary laparotomy for adhesive obstruction. Five of them had a single band and might have benefited from a laparoscopic approach.
Conclusions:
Laparoscopic management of adhesive bowel obstruction in children is feasible and safe in experienced hands. Early management saves the child a great deal of discomfort and allows a quick recovery with early discharge.