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Laparoscopic and open surgery methods in managing surgical intussusceptions: A randomized clinical trial of
Masoud Jamshidi1, Bahman Rahimi2, Neda Gilani3
1Pediatric Surgery Ward, Tabriz Medical Sciences' University, Tabriz, Iran.
Insights
Laparoscopic surgery (LS) for intussusception in infants is a valuable screening tool, potentially reducing open surgery (OS) rates. This approach demonstrated a lower postoperative complication rate compared to traditional open surgery.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Gastrointestinal Surgery
Background:
- Intussusception is a common surgical emergency in infants.
- Traditional open surgery (OS) for intussusception carries risks of postoperative complications.
- Laparoscopic surgery (LS) offers a minimally invasive alternative.
Purpose of the Study:
- To compare the postoperative complications of laparoscopic surgery (LS) versus open surgery (OS) in infant patients with intussusception.
- To evaluate the efficacy of LS as a diagnostic and therapeutic tool in surgical intussusception.
Main Methods:
- A double-blind, randomized clinical trial involving 52 infants (6-24 months) with intussusception.
- Patients were assigned to either LS (laparoscopic observation, hydrostatic enema, mechanical reduction) or OS (conventional technique).
- Follow-up was conducted for 2 years to compare postoperative complications.
Main Results:
- The laparoscopic surgery group had a lower postoperative complication rate (P ≤ 0.021).
- While operating time was longer in the LS group (P ≤ 0.006), fewer patients required bowel resections compared to OS.
- The conversion rate from LS to OS was 31%.
Conclusions:
- Laparoscopy serves as an effective screening tool to identify the need for open surgery in intussusception cases.
- Implementing LS can decrease the overall incidence of open surgery and associated complications in pediatric intussusception.
Purpose:
To compare postoperative complications of laparoscopic surgery (LS) with open surgery (OS) in surgical intussusception patients.
Methods:
From March 2015 to February 2018, infants between 6 to 24 months old had the clinical and sono-graphical signs of intussusception enrolled in this double-blind, randomized clinical trial. We divided surgical intussusception patients into two groups. In the LS group, we evaluated patients by direct laparoscopic observation, on-table hydrostatic enema, and mechanical reduction of intussusception. In the OS group, we performed the conventional technique. These patients were followed for 2 years after procedures for comparison of postoperative complications between the two groups.
Results:
We had 52 patients who needed surgical exploration (26 in each group). There were four (15%) and seven (27%) patients with self-reduced intussusception in LS and OS groups, respectively. The conversion rate was 31% (eight cases). Five cases (19%) in the LS group and four cases (15%) in the OS group needed bowel resections. Operating time was longer in the LS group (P ≤ 0.006), and the postoperative complication rate was higher in the OS group (P ≤ 0.021).
Discussion:
Laparoscopy is a screening tool to determine the need for OS in surgical intussusception patients. Laparoscopy reduces the incidence of OS and its complications.
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