Related Experiment Video
Updated: Feb 21, 2026
Laparoscopic Common Bile Duct Exploration in Patients with a Previous History of Biliary Tract Surgery
Published on: February 10, 2023
Laparoscopy or laparotomy for adhesive bowel obstruction in children: a systematic review and meta-analysis
Hiromu Miyake1,2, Shogo Seo1, Agostino Pierro3
1Division of General and Thoracic Surgery, The Hospital for Sick Children, University of Toronto, 1526-555 University Avenue, Toronto, ON, M5G 1X8, Canada.
Insights
Laparoscopy for adhesive small bowel obstruction (ASBO) in children may lead to fewer complications than laparotomy. However, current evidence is of very low quality, necessitating further research.
Area of Science:
- Pediatric surgery
- Gastrointestinal surgery
- Minimally invasive surgery
Background:
- Adhesive small bowel obstruction (ASBO) is a significant cause of postoperative morbidity in children.
- Laparoscopic approaches for pediatric ASBO have been reported but require detailed safety and efficacy evaluation.
Purpose of the Study:
- To compare the outcomes of laparoscopic versus open laparotomy for treating ASBO in pediatric patients.
- To evaluate the safety and efficacy of laparoscopic management for pediatric ASBO.
Main Methods:
- A systematic review and meta-analysis were conducted following PRISMA guidelines.
- Included studies were assessed for risk of bias using ROBINS-I, and evidence quality was evaluated using GRADE.
- The primary outcome was intraoperative and postoperative complications; the secondary outcome was length of hospital stay.
Main Results:
- Three observational studies were included; no randomized controlled trials were identified.
- Laparoscopy was associated with significantly fewer complications compared to laparotomy (OR=0.51, p<0.01).
- The overall risk of bias was considered serious, and the quality of evidence was very low.
Conclusions:
- Laparoscopy for pediatric ASBO appears to reduce postoperative complications compared to laparotomy.
- The current evidence is of very low quality, limiting definitive conclusions.
- Well-controlled studies are required to confirm the efficacy of laparoscopy for pediatric ASBO.
Purpose:
Adhesive small bowel obstruction (ASBO) is one of the most important cause of postoperative morbidity in children who underwent abdominal surgery. Laparoscopic management for ASBO in pediatric patients has been reported. However, its safety and efficacy has not been evaluated in details. The aim of this study is to compare the outcomes of laparoscopy and laparotomy for the treatment of ASBO in children.
Methods:
A systematic review and meta-analysis were performed following the Cochrane Handbook for systematic reviews of intervention and the preferred reporting item for systematic reviews and meta-analysis (PRISMA) and a protocol registered in PROSPERO (CRD42017067914). The primary outcome was the number of intraoperative and postoperative complications. The secondary outcome was length of hospital stay. The risk of bias in non-randomized studies of interventions (ROBINS-I) tool was used to assess the risk of bias. Quality of evidence was summarized using the grades of recommendation, assessment, development and evaluation (GRADE) approach.
Results:
We identified three observational studies and no randomized controlled trials. The meta-analysis was done only for the primary outcome. Complications were significantly fewer after laparoscopy compared to laparotomy (Odds ratio = 0.51; 95% CI 0.40-0.66; p < 0.01; I 2: 0%). The overall risk of bias was considered serious.
Conclusions:
Our results, based on observational studies, indicate that laparoscopy for ASBO was associated with less postoperative complications compared to conventional laparotomy. However, the quality of evidence is very low. A well-controlled study is needed to assess the efficacy of laparoscopy for pediatric patients with ASBO.
