Department of Pediatric Surgery, Northwest Women and Children's Hospital, Xi'an, Shaanxi, China.
Department of Pediatrics, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
Eur J Pediatr Surg. 2022 Dec;32(6):469-476. doi: 10.1055/s-0042-1749437. Epub 2022 Jun 10.
We conducted a systematic review and meta-analysis to compare the efficacy and safety between laparoscopic reduction (LR) and open reduction (OR) of intussusception in infants and children. Literature searches were conducted to identify studies having compared LR and OR for children with intussusception failed to enema reduction. Parameters such as operative time, time to oral intake, length of hospital stay, overall postoperative complications, and recurrence were pooled and compared by meta-analysis. Among the 502 pediatric participants included in the 11 studies, 275 had received LR and 227 received OR. There were shorter length of hospital stays and time to oral intake with the LR approach compared with OR. However, no significant difference was found between LR and OR in the secondary outcome, such as the overall postoperative complications and recurrence. LR is a feasible, safe, and effective surgical procedure alternative to OR for pediatric intussusception. Compared with OR, LR has the advantage of shorter hospital stay and faster time to oral intake. Besides, the overall postoperative complications may be slightly lower in LR. We conclude that LR should be considered an acceptable option for children.
我们进行了系统评价和荟萃分析,比较了腹腔镜复位(LR)和开腹复位(OR)治疗婴儿和儿童肠套叠的疗效和安全性。检索文献以确定比较 LR 和 OR 治疗未能灌肠复位的肠套叠儿童的研究。通过荟萃分析比较了手术时间、开始口服摄入时间、住院时间、总体术后并发症和复发等参数。在纳入的 11 项研究的 502 名儿科参与者中,275 名接受了 LR,227 名接受了 OR。与 OR 相比,LR 组的住院时间和开始口服摄入时间更短。然而,LR 和 OR 在次要结局(如总体术后并发症和复发)方面没有发现显著差异。LR 是小儿肠套叠的一种可行、安全、有效的手术替代方法。与 OR 相比,LR 具有住院时间更短、开始口服摄入时间更快的优势。此外,LR 的总体术后并发症可能略低。我们得出结论,LR 应该被认为是儿童的一种可接受的选择。