Retrospective cohort study of minimally invasive surgical approaches for pediatric intussusception.

Abstract

Intussusception is a common pediatric emergency that causes significant morbidity and mortality, particularly in low- to middle-income countries. The laparoscopic management of intussusception following failed non-invasive methods remains a topic of debate. This study aims to evaluate the long-term outcomes of minimally invasive approaches for intussusception. A retrospective analysis was conducted on patients who underwent minimally invasive surgery for intussusception between January 2016 and December 2020 at our institution. Data on patient demographics, pre-operative and intra-operative variables, immediate postoperative complications, length of hospital stay, and long-term results were collected. A total of 181 patients underwent minimally invasive surgery, including 117 boys (64.6%) and 64 girls (35.4%), with a median age of 8 months (range: 2-134). The median hospital stay was 4 days. Thirty-nine patients underwent trans-umbilical mini-open reduction (MO group), while 142 had laparoscopic exploration after failed air enema reduction. Among them, 40 had successful laparoscopic reduction (LAP group), and 102 required conversion to laparoscopic-assisted mini-open reduction (LAMO group). No intra-operative or immediate postoperative complications were observed. Recurrence occurred in 13 patients (7.2%) after a median follow-up of 43 months, with 6 patients (3.3%) requiring laparoscopic adhesiolysis due to bowel adhesions. In conclusion, minimally invasive surgery for intussusception is a safe and feasible approach with excellent long-term outcomes.