The incidence of negative intraoperative findings after unsuccessful hydrostatic reduction of ileocolic intussusception in children: A retrospective analysis

• Published in: Journal of pediatric surgery Vol. 54; no. 3; pp. 500 - 506
• Main Authors: Kanglie, Maadrika M.N.P., de Graaf, Nanko, Beije, Femke, Brouwers, Elise M.J., Theuns-Valks, Sabine D.M., Jansen, Frits H., de Roy van Zuidewijn, Diederick B.W., Verhoeven, Bas, van Rijn, Rick R., Bakx, Roel
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2019
• Subjects: Adolescent; Child; Child, Preschool; Diagnostic Errors - statistics & numerical data; Female; Humans; Hydrostatic reduction; Ileal Diseases - diagnosis; Ileal Diseases - surgery; Incidence; Infant; Infant, Newborn; Intussusception; Intussusception - diagnosis; Intussusception - surgery; Laparoscopy; Laparoscopy - statistics & numerical data; Laparotomy; Laparotomy - statistics & numerical data; Male; Negative intraoperative findings; Netherlands; Pediatric surgery; Retrospective Studies; Treatment Outcome; Netherlands; Negative intraoperative findings; Pediatric surgery; Intussusception; Hydrostatic reduction; Laparoscopy; ICD; IV; PA; DRG; IRB; SN; Laparotomy; US
• ISSN: 0022-3468; 1531-5037; 1531-5037
• DOI: 10.1016/j.jpedsurg.2018.05.006

There is a lack of studies addressing the occurrence of negative intraoperative findings (that is the absence of intussusception) after an unsuccessful hydrostatic reduction of an ileocolic intussusception. The aim of this study is to determine the incidence of negative intraoperative findings after unsuccessful hydrostatic reduction of ileocolic intussusception. We conducted a multicentre retrospective study of all children aged 0–18 years treated for ileocolic intussusception from January 1, 2010 to December 31, 2015 in 9 Dutch hospitals. Primary outcome measure was the percentage of children without an intussusception during surgical exploration after unsuccessful hydrostatic reduction. In the study period 436 patients were diagnosed with an ileocolic intussusception. Of these, 408 patients underwent hydrostatic reduction of an ileocolic intussusception. 112 patients (27.5%) underwent surgery after an unsuccessful hydrostatic reduction. In 13 (11.6%) patients no intraoperative evidence of intussusception was found. Patients who underwent surgical intervention after unsuccessful hydrostatic reduction were significantly younger than patients who had a successful hydrostatic reduction; there was no gender difference. A substantial number of children (11.6%) underwent a laparotomy after unsuccessful hydrostatic reduction in whom no intussusception was found intraoperatively. We suggest initiating laparoscopy instead of laparotomy when surgery is necessary. Level II.