Laparoscopy in the Treatment of Children with Intussusception

A A Pereyaslov, A O Dvorakevych, O M Nykyforuk

Abstract


Intussusception is one of the main causes of intestinal obstruction in children that requires timely treatment. Despite the high efficacy of therapeutic methods of intussusception reduction, some patients need the surgery. The question of the surgery method choice, namely open laparotomy or laparoscopy, is still under debate.

The objective of the research was to summarize own experience of laparoscopy in children with an intussusception.

The research was grounded on the results of treatment of 28 children operated in the first surgical department of the Lviv Regional Children’s Clinical Hospital «OHMATDYT» during 2008-2015. Optical system Strayker 1088 HD (Germany) with the 3-, 5-mm laparoscopic equipment was used for laparoscopy. The reduction of intussusception was performed by the retrograde traction of small intestine with the sliding catches.

Laparoscopic intussusception reduction was successful in 67.9% of patients, conversion was conducted in 32.1% of patients. The main reasons for the conversion were the necrosis of intestinal loop needing resection, presence of the complex intussusception, and the presence of polyp clear to the ileocecal valve. In 10.7% patients the laparoscopic reduction was supplemented by per rectum pneumoreduction with the help of Richardons’ system. During the last year, in cases of intestine resection need, the video-assisted operations were applied, when the intestine mobilization was performed laparoscopically and anastomosis was applied extraperitonealy. Complications during laparoscopic reduction and in the postoperative period were not observed.

Laparoscopy is the safe and effective method of patients with the intussusception treatment. Thorough selection of patients for the laparoscopic intussusception reduction makes it possible to decrease the rate of conversion.


Keywords


children; intussusception; laparoscopy

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References


Apelt N, Featherstone N, Giuliani S. Laparoscopic treatment of intussusception in children: a systematic review. J Pediatr Surg. 2013; 48: 1789-1793. http://dx.doi.org/10.1016/j.jpedsurg.2013.05.024

Lee YW, Yang SI, Kim JM, Kim JY. Clinical features and role of viral isolates from stool samples of intussuception in children. Pediatr Gastroenterol Hepatol Nutr. 2013; 16: 162-170. http://dx.doi.org/10.5223/pghn.2013.16.3.162

Bonnard A, Demarche M, Dimitriu C, et al. 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. http://dx.doi.org/10.1016/j.jpedsurg.2007.11.022

Kao C, Tseng SH, Chen Y. Laparoscopic reduction of intussusception in children by a single surgeon in comparison with open surgery. Minim Invasive Ther Allied Technol. 2011; 20: 141-145. http://dx.doi.org/10.3109/13645706.2010.518801

Hill SJ, Koontz CS, Langness SM, Wulkan ML. Laparoscopic versus open reduction of intussusception in children: experience over a decade. J Laparoendosc Adv Surg Tech A. 2013; 23: 166-169. http://dx.doi.org/10.1089/lap.2012.0174

Wei C-H, Fu Y-W, Wang N-L, et al. Laparoscopy versus open surgery for idiopathic intussusception in children. Surg Endosc. 2015; 29: 668-672. http://dx.doi.org/10.1007/s00464-014-3717-1

Sadigh G, Zou KH, Razavi SA, et al. Meta-analysis of air versus liquid enema for intussusception reduction in children. AJR. 2015; 205: 542-549. http://dx.doi.org/10.2214/AJR.14.14060

Rubinstein JC, Liu L, Caty MG, Christison-Lagay ER. Pathologic leadpoint is uncommon in ileo-colic intussusception regardless of age. J Pediatr Surg. 2015; 50: 1665-1667.

http://dx.doi.org/10.1016/j.jpedsurg.2015.03.048

Sklar CM, Chan E, Nasr A. Laparoscopic versus open reduction of intussusception in children: a retrospective review and meta-analysis. J Laparoendosc Adv Surg Tech. A. 2014; 24: 518-522.

http://dx.doi.org/10.1089/lap.2013.0415

Zhang Y, Bai YZ, Li SX, et al. Sonographic findings predictive of the need for surgical management in pediatric patients with small bowel intussusceptions. Langenbecks Arch Surg. 2011; 396: 1035-1140. http://dx.doi.org/10.1007/s00423-011-0742-6

Buettcher M, Baer G, Bonhoeffer J, et al. Three-year surveillance of intussusception in children in Switzerland. Pediatrics. 2007; 120: 473-480. http://dx.doi.org/10.1542/peds.2007-0035

Flaum V, Schneider A, Ferreira CG, et al. Twenty years' experience for reduction of ileocolic intussusceptions by saline enema under sonography control. J Pediatr Surg. 2016; 51: 179-182. http://dx.doi.org/10.1016/j.jpedsurg.2015.09.022




DOI: http://dx.doi.org/10.21802/gmj.2016.3.27

Copyright (c) 2017 A A Pereyaslov, A O Dvorakevych, O M Nykyforuk

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