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Laparoscopic versus open reduction of idiopathic intussusception in children: an updated institutional experience
Jian Zhao1, Jun Sun2, Deyu Li1
1Department of Pediatric Surgery, Yangzhou Maternal and Child Health Hospital, Yangzhou, China.
Insights
Laparoscopic surgery for pediatric intussusception is safe and effective. This minimally invasive approach offers shorter hospital stays and faster oral intake compared to open surgery.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Gastrointestinal Surgery
Background:
- Evidence for laparoscopic reduction of pediatric intussusception is limited.
- Further studies are needed to compare laparoscopic and open surgical approaches.
Purpose of the Study:
- To compare outcomes of laparoscopic versus open reduction for idiopathic intussusception in children.
- To highlight laparoscopic techniques for intussusception reduction.
Main Methods:
- Retrospective review of 162 pediatric patients with idiopathic intussusception.
- Comparison of outcomes between laparoscopic (LAP) and open laparotomy (OPEN) groups.
- Data analysis included demographics, clinical presentation, operative details, and complications.
Main Results:
- No significant differences in demographics or intussusception characteristics between LAP and OPEN groups.
- Laparoscopic surgery resulted in significantly shorter hospital stays.
- Excluding conversions, laparoscopic surgery showed significantly shorter operation times and faster oral intake.
Conclusions:
- Laparoscopic reduction is a safe and effective treatment for pediatric idiopathic intussusception.
- Pediatric surgeons should consider laparoscopy as a primary treatment option for intussusception.
Background:
In the reduction of intussusception, due to the lack of randomized, controlled, and prospective clinical trials to confirm the superiority of the laparoscopic approach over open surgery, more evidence was needed. This study aimed to compare the results of laparoscopy and open reduction of idiopathic intussusception in children as well as to illustrate some skills for the reduction of intussusception laparoscopically.
Methods:
A retrospective review was performed to evaluate outcomes for patients with idiopathic intussusception who were treated laparoscopically (LAP group) from January 2015 to December 2019 and to compare the outcomes with laparotomy (OPEN group) during the same period.
Results:
During the period studied, there were 162 patients treated surgically for intussusception: 62 LAP and 100 OPEN. No statistical differences were found in demographic data, clinical symptoms and signs, duration of symptoms, location and types of intussusception between the two groups. Conversion to open procedure was required for 11 patients in the LAP group. The operation time and time to oral intake were shorter in the LAP group while the difference was not significant. If the 11 conversion cases were excluded, the operation time and time to oral intake were significantly shorter (P < 0.05) in the LAP group. The length of stay was significantly shorter in the LAP group (P < 0.05). Intraoperative and postoperative complication rates between the two groups were comparable (P = 1.0).
Conclusion:
Laparoscopy was safe and effective in the treatment of pediatric idiopathic intussusceptions. Pediatric surgeons with sophisticated minimally invasive skills should choose laparoscopy as the first choice in the treatment of idiopathic intussusceptions.
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