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Murine Ileocolic Bowel Resection with Primary Anastomosis
Published on: October 29, 2014
Incidental appendectomy in surgical treatment of ileocolic intussusception in children. Is it safe to perform?
C Delgado-Miguel1, A García2, B Delgado3
1Department of Pediatric Surgery. Prisma Health Children's Hospital. Columbia, South Carolina (USA). Department of Pediatric Surgery. La Paz Children's Hospital. Madrid (Spain).
Insights
Performing incidental appendectomy during ileo-colic intussusception surgery in children is safe. It does not increase complications, operative time, or hospital stay, offering a valuable surgical option.
Area of Science:
- Pediatric Surgery
- Gastrointestinal Surgery
Background:
- Ileo-colic intussusception (ICI) is a common cause of emergency laparotomy in children.
- The role of incidental appendectomy following ICI reduction remains debated.
- This study evaluates outcomes of incidental appendectomy with or without bowel resection in ICI cases.
Purpose of the Study:
- To determine the safety and impact of incidental appendectomy in children undergoing surgical treatment for ileo-colic intussusception.
- To compare outcomes between patients who had an associated appendectomy and those who did not.
- To analyze the influence of concomitant bowel resection on outcomes.
Main Methods:
- Retrospective analysis of 101 pediatric patients with ICI treated surgically between 2005-2019.
- Patients were divided into two groups: associated appendectomy (AA) and no appendectomy (NA).
- Stratified analysis was conducted based on the need for bowel resection.
Main Results:
- No significant differences in demographics or intraoperative findings between AA and NA groups.
- Surgical time and hospital stay were similar between groups (55.7 min vs. 61.2 min; median 5 days).
- Postoperative complications and recurrence rates were comparable, with bowel resection increasing operative time, hospital stay, and complications.
Conclusions:
- Incidental appendectomy in pediatric ileo-colic intussusception surgery is a safe procedure.
- It does not adversely affect operative time, hospital stay, postoperative complications, or recurrence rates.
- The findings support the consideration of incidental appendectomy in selected cases.
Background:
Surgical treatment of ileo-colic intussusception (ICI) has been reported as the second cause of emergency laparotomy in children. The performance of incidental appendectomy after surgical reduction is currently controversial. The aim is to analyse the outcomes of performing incidental appendectomy after surgical ICI reduction with or without associated bowel resection.
Materials And Methods:
A retrospective study was performed in patients with ICI episodes, who underwent surgical treatment in our institution between 2005-2019. Patients were divided in two groups according to the performance of associated appendectomy (AA group) or not (NA group). Subsequently, a stratified analysis was performed according to the need for bowel resection in both groups. Demographic variables, intraoperative findings, surgical time, hospital stay, postoperative complications and recurrences were analysed.
Results:
A total of 101 patients (77 AA group; 24 NA group) were included, without differences in demographics or intraoperative findings. A total of 36 bowel resections were performed (24 group AA; 10 group NA), with no differences in surgical time (55.7 min in group AA vs. 61.2 min in group NA; p = 0.587) or hospital stay (median 5 days in both groups). There were also no differences in postoperative complications or recurrences between the two groups. Stratified analysis showed that bowel resection increases operative time, hospital stay and postoperative complications, regardless of whether associated appendectomy was performed or not.
Conclusions:
Incidental appendectomy during surgical treatment of ICI in children is a safe procedure that does not increase operative time, hospital stay, postoperative complications or recurrence.
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