The role of laparoscopy in the management of childhood intussusception.

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.