Laparoscopic approach to small intestinal obstruction in children: a preliminary experience.

SUMMARY: The use of laparoscopy for the management of acute intestinal obstruction is increasing. It has potential advantages over classic laparotomy. The objective of the current study was to evaluate the feasibility and outcome of laparoscopic management of small intestinal obstruction. A retrospective review of 30 children admitted for attempt of laparoscopic management of acute intestinal obstruction was performed. Their mean age was 6.7 +/- 1.73 years. Of the 30 laparoscopic attempts, 20 (66.7%) were performed successfully, whereas 10 patients (33.3%) needed a conversion to laparotomy because of inadequate laparoscopic visualization in 6 cases, gangrenous bowel in 2 cases, and inability to relieve the obstruction laparoscopically in 2 cases. There were no intra-or postoperative complications in the laparoscopic group. The mean operative time for the laparoscopic release of intestinal obstruction was 68 +/- 12.32 minutes and 102 +/- 9.67 minutes for the converted cases. The mean time of return of bowel function and mean hospital stay in the laparoscopic release of intestinal obstruction were significantly shorter. The study showed that laparoscopic release of intestinal obstruction in children is worthy of attempting initially. It is a feasible, effective, and safe alternative to laparotomy for most patients with acute intestinal obstruction.