Prospective Evaluation of Laparoscopy in Management of Infantile Intussusception

Abstract
Background: Laparoscopy was initially utilized as a diagnostic tool for failed reduction of intussusception and then was tried as an aid to hydrostatic reduction and recently laparoscopy is used as a definitive treatment.
Aim of Study: In this study we are trying to evaluate the role of laparoscopy in management of infantile intussusception.
Patients and Methods: This prospective study was con-ducted on 58 childern suffering from intussusception, admitted to the Pediatric Surgery Unit of Tanta University Hospital from June 2017 to June 2018.
Results: Our study included 58 patients with intussuscep-tion with a mean age of 10.95 months. 32 (55.2%) presented early with mild symptoms, 38 (65.5%) showed red currant jelly stool, 37 (63.8%) presented with intestinal obstruction, and 3 (5.2%) showed signs of peritonitis. Mass was sub-hepatic in 33 infants (56.9%). Hydrostatic reduction was attempted in stable cases (55) and 3 cases with peritonitis underwent immediate laparotomy. Of 55 cases, 39 (71%) were successfully managed using hydrostatic reduction. Laparo-scopic reduction was attempted in 16 (29%) cases, 12 (75%) were completed laparoscopically and 4 (25%) cases were converted to laparotomy, one reduced manually and 3 cases had bowel resection. Operative time ranged between 30-180 with a mean of 83.95 minutes. Mean hospital stay was 1.8 days. One case had port site hernia (1.7%) and there was no recurrence detected in any case. Follow-up ranged between 1-12 months.
Conclusion: Laparoscopic reduction of idiopathic intus-susception is safe, feasible and provides minimally invasive approach with significantly early oral feeding and reduced hospital stay.