Laparoscopic Ileocolic Pexy as Preventive Treatment Alternative for Ileocolic Intussusception With Multiple Recurrences in Children
| Autor: | Feng-Nian Zhang, Bing Li, Wei-Bing Chen, Chun-Xia Sun |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Operative Time 03 medical and health sciences 0302 clinical medicine Blood loss Intussusception (medical disorder) medicine Secondary Prevention Humans Laparoscopy Retrospective Studies medicine.diagnostic_test business.industry Ileal Diseases Infant Retrospective cohort study Ileocolic intussusception Enema medicine.disease Surgery Bowel obstruction Meckel Diverticulum Treatment Outcome 030220 oncology & carcinogenesis Child Preschool Operative time 030211 gastroenterology & hepatology Female business Intussusception |
| Zdroj: | Surgical laparoscopy, endoscopypercutaneous techniques. 28(5) |
| ISSN: | 1534-4908 |
| Popis: | PURPOSE Idiopathic intussusception is one of the most common causes of small bowel obstruction in children. To decrease subsequent recurrence and to detect a lead point, an early laparoscopy was performed for children with multiple recurrent ileocolic intussusception. MATERIALS AND METHODS Between January 2014 and July 2017, a total of 2561 consecutive children with intussusception were treated and followed. There were 110 patients with multiple recurrences, 61 were treated with ileocolic pexy and 49 were not and the results were compared. Using a 5-mm laparoscope and 2 additional transabdominal wall stab incisions, an appendectomy and an ileocolic pexy with nonabsorbable sutures were performed simultaneously for the children after the last successful enema reduction. RESULTS The mean operative time was 59.4±13.1 minutes (range, 45 to 85 min). No cases required conversion to an open surgery, blood loss was minimal. There was no operative morbidity. Two patients were found with a Meckel's diverticulum, and were removed by slightly enlarged transumbilical incision. The 61 cases were followed up for 4 to 42 months (mean, 19.3±1.1 mo). In the ileocolic pexy group, 2 of 61 (3.2%) got 2 episodes of recurrences. Among the 25 patients with 3 recurrences without undergoing ileocolic pexy, 18 (72%) had 22 episodes of recurrence. Of the 16 patients with 4 recurrences and without ileocolic pexy, 14 (87.5%) had 17 episodes of recurrence. There was statistical difference in recurrent rate among the 3 groups (ileocolonic pexy group vs. 3 recurrences group, P |
| Databáze: | OpenAIRE |
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