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Laparoscopic versus open reduction of intussusception in children: a single-institution comparative experience
Karen A Bailey1, Paul W Wales, J Ted Gerstle
1Division of General Surgery, Hospital for Sick Children, Toronto, Ontario, Canada M5G 1X8.
Background:
The role of laparoscopic surgery in treating intussusception has been controversial. This study reviews our institution's experience with the laparoscopic approach (LAP) compared to the open surgical approach (OPEN).
Methods:
Retrospective analysis of all patients undergoing surgery for intussusception at our center from January 2002 to February 2006. Statistical assessment included Student's t test and chi2 analysis.
Results:
A total of 41 patients required operation for intussusception (18 LAP, 23 OPEN). Mean age was 22 months for LAP and 11 months for OPEN (P = .17). In the LAP group, 28% (5/18) were converted to an open procedure. Operative times and complications were not significantly different. Pathologic lead points were found in 33% (6/18) LAP and 35% (8/23) OPEN patients (P = 1.0). Time to full feeds was significantly shorter (LAP vs OPEN: 3.4 +/- 2.7 vs 5.6 +/- 3.4 days, P = .02). Length of stay was shorter (LAP vs OPEN: 4.8 +/- 3.5 vs 9.1 +/- 7.5 days, P = .03).
Conclusions:
Intussusception can be treated safely and effectively using a LAP with a significant decrease in time to full feeds and length of stay. The LAP should be considered as the initial approach for stable patients with intussusception requiring operative intervention.
