Abstract
Background
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.
Methods
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.
Results
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.
Conclusions
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.
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References
Agha FP (1986) Intussusception in adults. Am J Roentgenol 146: 527–531
Bisset GS, Kirks DR (1988) Intussusception in infants and children: diagnosis and therapy. Radiology 168: 141–145
Chen MK, Schropp KP, Lobe TE (1996) Complications of minimalaccess surgery in children. J Pediatr Surg 31: 1161–1165
Choi SO, Park WH, Woo SK (1994) Ultrasound-guided water enema: an alternative method of nonoperative treatment for childhood intussusception. J Pediatr Surg 29: 498–500
Cuckow PM, Slater RD, Najmaldin AS (1996) Intussusception treated laparoscopically after failed air enema reduction. Surg Endosc 10: 671–672
Cull DL, Rosario V, Lally KP, Ratner I, Mahour GH (1990) Surgical complications of Henoch-Schönlein purpura. J Pediatr Surg 25: 741–743
Daneman A, Alton DJ, Lobo E, Gravett J, Kim P, Ein SH (1998) Patterns of recurrence of intussusception in children: a 17-year review. Pediatr Radiol 28: 913–919
Don S, Cohen MD, Wells LJ, Rescorla FJ (1992) Air reduction of an intussusception caused by a pathogenic lead point in an infant. Pediatr Radiol 22: 326–327
Ein SH (1976) Leading points in childhood intussusception. J Pediatr Surg 11: 209–211
Ein SH, Palder SB, Douglas JA, Daneman A (1994) Intussusception: toward less surgery? J Pediatr Surg 29: 433–435
Guo JZ, Ma XY, Zhou QH (1986) Results of air pressure enema reduction of intussusception: 6396 cases in 13 years. J Pediatr Surg 21: 1201–1203
Katz ME, Kolm P (1992) Intussusception reduction 1991: an international survey of paediatric radiologists. Pediatr Radiol 22: 318–322
Lam AH, Firman K (1991) Ultrasound of intussusception with lead points. Australas Radiol 35: 343–345
Meyer JS (1992) The current radiological management of intussusception: a survey and review. Pediatr Radiol 22: 323–325
Pierro A, Donnell SC, Paraskevopoulou C, Carty H, Lloyd DA (1993) Indications for laparotomy after hydrostatic reduction for intussusception. J Pediatr Surg 28: 1154–1157
Réguerre Y, de Dreuzy O, Boithias C, Lacaze-Masmonteil T, André P, Dehan M (1998) Une cause méconnue d’ascite fœtale: l’invagination intestinale aiguü. Arch Pediatr 4: 1197–1199
Reijnen JA, Festen C, Joosten HJ, Van Wieringen PM (1990) Atypical characteristics of a group of children with intussusception. Acta Paediatr Scand 79: 675–679
Reijnen JA, Joosten HJ, Festen C (1987) Intussusception in children 5–15 years of age. Br J Surg 74: 692–693
Schleicher C, Schickedanz H, Neumann R (1982) Klinisch-röntgenologische Befunde beim Invagination sileus im kindesalter. Radiol Diagn Berl 23: 342–352
Schier F (1997) Experience with laparoscopy in the treatment of intussusception. J Pediatr Surg 32: 1713–1714
Shekhawat NS, Prabhakar G, Sinha DD, Goyal RB, Gupta A, Sharma RK, Sogani KC (1992) Nonischemic intussusception in childhood. J Pediatr Surg 27: 1433–1435
Verschelden P, Filiatrault D, Garel L, Grignon A, Perreault G, Boisvert J, Dubois J (1992) Intussusception in children: reliability of US in diagnosis—a prospective study. Radiology 184: 741–744
Zheng JY, Fresh DP, Guo JZ (1994) Review of pneumatic reduction of intussusception: evolution not revolution. J Pediatr Surg 29:93–97
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Online publication: 6 February 2001
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van der Laan, M., Bax, N.M.A., van der Zee, D.C. et al. The role of laparoscopy in the management of childhood intussusception. Surg Endosc 15, 373–376 (2001). https://doi.org/10.1007/s004640090044
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DOI: https://doi.org/10.1007/s004640090044