The role of laparoscopy in the management of childhood intussusception

• Published in: Surgical endoscopy Vol. 15; no. 4; pp. 373 - 376
• Main Authors: VAN DER LAAN, M, BAX, N. M. A, VAN DER ZEE, D. C, URE, B. M
• Format: Journal Article
• Language: English
• Published: New York, NY Springer 01.04.2001; Springer Nature B.V
• Subjects: Age; Age Factors; Biological and medical sciences; Child; Child, Preschool; Children & youth; Female; Hospitals; Humans; Ileocecal Valve - surgery; Intestinal obstruction; Intussusception - diagnosis; Intussusception - surgery; Laparoscopy; Laparoscopy - methods; Laparoscopy - statistics & numerical data; Male; Medical diagnosis; Medical sciences; Patients; Recurrence; Retrospective Studies; Stomach, duodenum, intestine, rectum, anus; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Ultrasonic imaging; Human; Endoscopic surgery; Open reduction; Treatment; Indication; Intussusception; Gut; Digestive diseases; Intestinal disease; Selection criterion; Laparoscopy; Child
• ISSN: 0930-2794; 1432-2218
• DOI: 10.1007/s004640090044

Some authors have argued that intussusception is best treated via a laparoscopic approach. As we did not have this impression, we reviewed our experience with this condition. : We reviewed all patients with intussusception who were treated at our hospital over the past 10 years. The choice of whether to use a laparoscopic or open approach depended on the patient's clinical condition and the availability of surgeons with laparoscopic expertise. A total of 72 patients were identified. Based on age, two subgroups were distinguished-one comprised of patients under the age of 3 years and one of patients over the age of 3 years. Sixty-five patients were under 3 years of age. Thirty-five had surgery, and 19 required resection. Of the 10 patients who were treated with a laparoscopic approach, only three could be reduced laparoscopically. After conversion in the other seven patients, the intussusception was reduced in five whereas a resection was required in two cases. Seven patients were 3 years of age or older. All of them underwent surgery, and all but one required resection. All four children who were laparoscoped subsequently had a bowel resection at open surgery. Patients 3 years of age or older usually need resection and will not benefit from the laparoscopic approach. Under 3 years of age, little is to be gained from a laparoscopic approach, provided good nonsurgical reduction facilities are available. There is a place for the laparoscopic approach in cases of recurrent intussusception or doubtful reduction.