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[Diagnosis and treatment of adhesive intestinal obstruction in children]

Iu F Isakov, E A Stepanov, A F Dronov

    Khirurgiia
    |August 1, 1990
    PubMed

    Insights

    This study on acute adhesive intestinal obstruction in 455 patients found that minimally invasive laparoscopy corrected obstruction in nearly half of pediatric cases, avoiding surgery. The overall mortality rate was low at 1.3%.

    Area of Science:

    • Gastroenterology and Surgical Innovation
    • Pediatric Surgery
    • Medical Device Technology

    Context:

    • Acute adhesive intestinal obstruction is a significant surgical challenge, particularly in pediatric populations.
    • Traditional management often involves open laparotomy, carrying substantial morbidity.
    • The study addresses the need for less invasive diagnostic and therapeutic strategies.

    Purpose:

    • To evaluate the efficacy and safety of laparoscopic interventions for acute adhesive intestinal obstruction in children.
    • To analyze the common etiologies and outcomes of surgical management, including novel techniques like medical glue application.
    • To assess the diagnostic accuracy of laparoscopy in suspected cases.

    Summary:

    • Analyzed 455 patients (194 children) with acute adhesive intestinal obstruction, identifying appendicitis, developmental anomalies, and intussusception as primary causes.
    • Investigated complete viscerolysis and horizontal intestinoplication using medical glue without sutures in 34 cases, even during the acute phase.
    • Laparoscopy in 90 children confirmed diagnoses in 64, successfully correcting intestinal obstruction and avoiding laparotomy in almost half of these patients.
    • Severe gastrointestinal paresis/paralysis indicated decompression, and the overall mortality rate was 1.3%.

    Impact:

    • Demonstrates laparoscopy as a viable and effective alternative to laparotomy for pediatric acute adhesive intestinal obstruction, reducing the need for open surgery.
    • Highlights the potential of novel techniques like medical glue in managing adhesions, potentially improving patient outcomes.
    • Provides valuable data on diagnostic accuracy and management strategies, contributing to evidence-based pediatric surgical practice.

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