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Objective To summarize our experience in laparoscopic treatment of intussusception in children who failed fluoroscopy-guided pneumatic enema reduction, and to identify the independent risk factors that may relate to conversion to open approach.Methods A retrospective analysis of patients with intussusception who failed pneumatic enema reduction was performed from August 2014 to March 2021. Patients who completed laparoscopic intussusception reduction were compared with those who converted to open approach regarding demographic (age, gender), history (previous abdominal surgery history, number (No.) of intussusception before), clinical manifestations (preoperative pneumatic enema attempts, abdominal pain, irritable crying, emesis, bloody stool, abdominal mass, fever, diarrhea, duration of symptoms, body mass index, American Society of Anesthesiologists fitness grade), work-up (Leukocyte counts), and intra-operative findings (anatomic type of intussusception, number (No.) of intussusceptions, length of intussusception, outcome (operative time, complications, postoperative hospital stay). Statistic analyze was performed using univariate and Logistic regression analysis. Results Univariate analysis showed that small bowel intussusception was associated with conversion to laparotomy (p < 0.05). Logistic regression analysis indicated that bloody stool (odds ratio (OR)26.071; 95% confidence interval (CI)2.341,290.33; p < 0.01) and small bowel intussusception (odds ratio (OR)39.194; 95% confidence interval (CI)3.562,431.281; p < 0.01) may be independent risk factors related to the conversion from laparoscopic intussusception to open procedure (p < 0.01).Conclusion Bloody stool and small bowel intussusception may be the independent risk factors associated with the conversion to laparotomy in laparoscopic treatment for intussusception in children who failed fluoroscopy-guided pneumatic enema reduction. |
