Aim
To evaluate the efficiency of laparoscopy in the management of primary infantile intussusception. Our primary outcomes were to evaluate the feasibility and safety of laparoscopic reduction of infantile intussusception.
Patients and methods
This prospective study included 92 children with infantile intussusception, admitted and managed in Pediatric Surgery Unit, Tanta University Hospital, from June 2018 to June 2021. All included infants were followed up for 6 months.
Results
Our study included 92 patients with intussusception, with a mean age of 8.61 months. A total of 87 (94.56%) cases presented early within 48 h of the initial complaint and with good general condition, and five (5.43%) cases presented late and/or with bad general condition and were managed with immediate laparotomy. Moreover, 64 (69.6%) showed red currant jelly stool, and 28 (30.4%) presented with intestinal obstruction. Hydrostatic reduction was attempted in 87 stable cases. In addition, 55 (63.2%) were successfully managed using hydrostatic reduction. Recurrence occurred in four cases, and hydrostatic reduction was repeated successfully. Laparoscopic intervention was attempted in 32 (36.78%) cases after failure of hydrostatic reduction, and 27 (84.37%) were completely reduced laparoscopically. Five (15.6%) cases were converted to laparotomy, where two were manually reduced and three cases underwent bowel resection. Operative time ranged between 49 and 180 min, with a mean of 89.05 min. The mean hospital stay was 1.75 days. Mild surgical site infection occurred in 3/10 laparotomy cases and 1/27 laparoscopic cases. There was no recurrence detected within 6-month postoperative follow-up period. Scars of laparoscopy were almost invisible after 6 months compared with exploratory laparotomy.
Conclusion
n Laparoscopic reduction of idiopathic intussusception is feasible and provides minimally invasive approach with excellent results, significantly reduced hospital stay, and better cosmesis.