Abstract
Intussusception is common cause of intestinal obstruction in children. Most of intussusceptions can be treated with non-operative reduction using air or barium. However, about 10% patients need operative treatment due to failure of reduction, peritonitis, and recurrence after reduction. We introduce our experience of laparoscopic surgery for intussusception. From April 2010 to March 2013, we reviewed 57 children who diagnosed intussusception. Twelve patients underwent an operation. The cause of operation was 7 of failure of air reduction and 5 of recurrence after air reduction. Median age was 21.5 months (range: 5.0~57.7 months) and 11 children (91.7%) underwent successful laparoscopic reduction. Median operating time was 50 minutes (range: 30~20 minutes) and median hospital days was 4.5 days (range: 3~8 days). One patient had a leading point as a heterotopic pancreas and underwent bowel resection through conversion. There was neither intra-operative nor postoperative complication. Laparoscopic reduction for intussusception can bring an excellent cosmetic effect with high success rate.
Figures and Tables
References
1. Seifarth FG, Ryan ML, Triana J, Knight CG. Diagnosis and laparoscopic treatment of ileoileal intussusceptions secondary to heterotopic pancreas in an infant: case report and review of the literature. J Pediatr Surg. 2011; 46:E33–E36.
2. Ravitch MM, McCune RM. Reduction of intussusception by barium enema: clinical and experimental study. Ann Surg. 1948; 128:904–917.
3. Meyer JS, Dangman BC, Buonomo C, Berlin JA. Air and liquid contrast agents in the management of intussusception: a controlled, randomized trial. Radiology. 1993; 188:507–511.
4. Sorantin E, Lindbichler F. Management of intussuception. Eur Radiol. 2004; 14:L146–L154.
5. Eshed I, Witzling M, Gorenstein A, Serour F. Reduction of intussusceptions by air enema in children-experience over a 13-year period. Harefuah. 2003; 142:659–661. 719720
6. Navarro OM, Daneman A, Chae A. Intussusception: the use of delayed, repeated reduction attempts and the management of intussusceptions due to pathologic lead points in pediatric patients. AJR Am J Roentgenol. 2004; 182:1169–1176.
7. van den Ende ED, Allema JH, Hazebroek FW, Breslau PJ. Success with hydrostatic reduction of intussusception in relation to duration of symptoms. Arch Dis Child. 2005; 90:1071–1072.
8. Kia KF, Mony VK, Drongowski RA, Golladay ES, Geiger JD, Hirschl RB, Coran AG, Teitelbaum DH. Laparoscopic vs open surgical approach for intussusception requiring operative intervention. J Pediatr Surg. 2005; 40:281–284.
9. Schier F. Experience with laparoscopy in the treatment of intussusception. J Pediatr Surg. 1997; 32:1713–1714.
10. Hay SA, Kabesh AA, Soliman HA, Abdelrahman AH. Idiopathic intussusceptions: the role of laparoscopy. J Pediatr Surg. 1999; 34:577–578.
11. van der Laan M, Bax NM, van der Zee DC, Ure BM. The role of laparoscopy in the management of childhood intussusception. Surg Endosc. 2001; 15:373–376.
12. Fraser JD, Aguayo P, Ho B, Sharp SW, Ostlie DJ, Holcomb GW 3rd, St Peter SD. Laparoscopic management of intussusception in pediatric patients. J Laparoendosc Adv Surg Tech A. 2009; 19:563–565.
13. Bonnard A, Demarche M, Dimitriu C, Podevin G, Varlet F, François M, Valioulis I, Allal H. GECI (Groupe d'Etude de Coelioscopie Pédiatrique). Indications for laparoscopy in the management of intussusception: A multicenter retrospective study conducted by the French Study Group for Pediatric Laparoscopy (GECI). J Pediatr Surg. 2008; 43:1249–1253.
14. Burjonrappa SC. Laparoscopic reduction of intussusception: an evolving therapeutic option. JSLS. 2007; 11:235–237.
15. Cheung ST, Lee KH, Yeung TH, Tse CY, Tam YH, Chan KW, Yeung CK. Minimally invasive approach in the management of childhood intussusceptions. ANZ J Surg. 2007; 77:778–781.
16. Choi KJ. Analysis of clinical factors and operative findings in childhood intussusceptions. J Korean Assoc Pediatr Surg. 1996; 2:81–87.
17. Park BC, Kim SY, Jung SJ. A comparative analysis of clinical features and treatment outcomes of intussusception according to age distribution. Korean J Pediatr Gastroenterol Nutr. 2005; 8:150–156.
18. Bailey KA, Wales PW, Gerstle JT. Laparoscopic versus open reduction of intussusception in children: a single-institution comparative experience. J Pediatr Surg. 2007; 42:845–848.
19. Almaramhy HH. Laparoscopic reduction of intussusception in children: role in primary and revisional reduction after failed non-surgical therapies. Int J Health Sci (Qassim). 2011; 5:71–78.