Pediatric Surgery Ward, Tabriz Medical Sciences' University, Tabriz, Iran.
General Surgery Ward, Tabriz Medical Sciences' University, Tabriz, Iran.
Asian J Endosc Surg. 2022 Jan;15(1):56-62. doi: 10.1111/ases.12965. Epub 2021 Jul 12.
To compare postoperative complications of laparoscopic surgery (LS) with open surgery (OS) in surgical intussusception patients.
From March 2015 to February 2018, infants between 6 to 24 months old had the clinical and sono-graphical signs of intussusception enrolled in this double-blind, randomized clinical trial. We divided surgical intussusception patients into two groups. In the LS group, we evaluated patients by direct laparoscopic observation, on-table hydrostatic enema, and mechanical reduction of intussusception. In the OS group, we performed the conventional technique. These patients were followed for 2 years after procedures for comparison of postoperative complications between the two groups.
We had 52 patients who needed surgical exploration (26 in each group). There were four (15%) and seven (27%) patients with self-reduced intussusception in LS and OS groups, respectively. The conversion rate was 31% (eight cases). Five cases (19%) in the LS group and four cases (15%) in the OS group needed bowel resections. Operating time was longer in the LS group (P ≤ 0.006), and the postoperative complication rate was higher in the OS group (P ≤ 0.021).
Laparoscopy is a screening tool to determine the need for OS in surgical intussusception patients. Laparoscopy reduces the incidence of OS and its complications.
比较腹腔镜手术(LS)与开放手术(OS)治疗小儿肠套叠术后并发症。
2015 年 3 月至 2018 年 2 月,对 6 至 24 个月大的具有肠套叠临床和超声征象的婴儿进行了这项双盲、随机临床试验。我们将肠套叠患者分为两组。在 LS 组中,我们通过直接腹腔镜观察、桌上水压灌肠和机械复位来评估患者。在 OS 组中,我们采用常规技术。两组患者均在手术后随访 2 年,比较两组术后并发症。
我们有 52 名需要手术探查的患者(每组 26 名)。LS 组有 4 例(15%)和 OS 组有 7 例(27%)患者发生自行复位。转换率为 31%(8 例)。LS 组中有 5 例(19%)和 OS 组中有 4 例(15%)需要肠切除术。LS 组的手术时间较长(P≤0.006),OS 组的术后并发症发生率较高(P≤0.021)。
腹腔镜是确定小儿肠套叠患者是否需要 OS 的筛查工具。腹腔镜可以降低 OS 及其并发症的发生率。