Open transumbilical intussusception reduction in children: A prospective study
Ning Li1, Qiao Bao1, Jiyan Yuan1
1Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
Insights
Open transumbilical intussusception reduction (OTIR) is a safe and effective alternative to laparoscopic reduction (LAP) for children. OTIR offers shorter operative times and lower costs, making it a valuable option for intussusception treatment.
Area of Science:
- Pediatric Surgery
- Gastrointestinal Surgery
Background:
- Intussusception is a common surgical emergency in children.
- Manual reduction may be necessary when non-surgical methods fail.
Purpose of the Study:
- To compare the safety and efficacy of open transumbilical intussusception reduction (OTIR) versus laparoscopic reduction (LAP).
Main Methods:
- Prospective randomized trial of clinically stable children with intussusception who failed pneumatic reduction.
- Comparison of reduction rates, complications, operative times, and costs between OTIR and LAP groups.
Main Results:
- OTIR group (n=27): 22 successful reductions, mean operative time 47.7 min, mean cost $1259.74.
- LAP group (n=24): 5 conversions to open surgery, mean operative time 68.63 min, mean cost $1750.63.
- No severe complications in either group.
Conclusions:
- OTIR is as safe and effective as LAP for pediatric intussusception reduction.
- OTIR demonstrates shorter operative times and lower costs compared to LAP.
- OTIR presents a viable and cost-effective treatment option for intussusception in children.
Purpose:
Manual intussusception reduction can sometimes be accomplished through the existing umbilical incision after a laparoscopic attempt has failed. We compared the safety and efficacy of open transumbilical intussusception reduction (OTIR) and laparoscopic reduction (LAP).
Methods:
We prospectively enrolled children diagnosed with intussusception at our hospital from June 2014 to December 2018. Clinically stable patients who failed pneumatic intussusception reduction were randomly assigned to the OTIR or LAP group. We compared reduction rates, complications, operative times, and surgery costs between the two groups.
Results:
Fifty-one of 451 patients with an intussusception met the study criteria. In the OTIR group (n = 27), 22 intussusceptions were successfully reduced, and 5 required incision extension. The mean operative time was 47.7 ± 10.5 min, and mean surgery cost was 1259.74 ± 46.24 US dollars. In the LAP group (n = 24), 5 patients required conversion to open surgery. Three of the 5 cases were resolved by OTIR, while the other 2 needed incision extension. The mean operative time was 68.63 ± 17.13 min, and mean surgery cost was 1750.63 ± 106.98 US dollars. Severe complications did not occur in either group.
Conclusions:
OTIR was as safe and effective as LAP and had a shorter operative time and lower surgery cost. OTIR is a good option for intussusception reduction in children.
Type Of Study:
Treatment study.
Levels Of Evidence:
Level I.
