Department of Pediatric Surgery, The National Hospital of Pediatrics, Hanoi, Vietnam.
College of Health Science, VinUniversity, Hanoi, Vietnam.
Sci Rep. 2024 Nov 30;14(1):29763. doi: 10.1038/s41598-024-81654-x.
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.
肠套叠是一种常见的儿科急症,会导致较高的发病率和死亡率,尤其是在中低收入国家。对于非侵入性方法治疗失败的肠套叠,腹腔镜治疗仍然存在争议。本研究旨在评估微创方法治疗肠套叠的长期效果。对 2016 年 1 月至 2020 年 12 月在我院接受微创治疗肠套叠的患者进行回顾性分析。收集患者的人口统计学、术前和术中变量、术后即刻并发症、住院时间和长期结果的数据。共 181 例患者接受微创治疗,其中男 117 例(64.6%),女 64 例(35.4%),中位年龄为 8 个月(范围:2-134 个月)。中位住院时间为 4 天。39 例患者接受经脐小切口微创复位(MO 组),142 例患者在空气灌肠复位失败后行腹腔镜探查。其中,40 例成功行腹腔镜复位(LAP 组),102 例需要转为腹腔镜辅助小切口微创复位(LAMO 组)。术中及术后即刻均无并发症发生。中位随访 43 个月后,13 例患者(7.2%)出现复发,其中 6 例(3.3%)因肠粘连需行腹腔镜粘连松解术。总之,微创治疗肠套叠是一种安全可行的方法,具有良好的长期效果。