Maadrika M N P Kanglie1, Nanko de Graaf2, Femke Beije3, Elise M J Brouwers4, Sabine D M Theuns-Valks5, Frits H Jansen6, Diederick B W de Roy van Zuidewijn7, Bas Verhoeven8, Rick R van Rijn9, Roel Bakx10. 1. Faculty of Medicine, University of Amsterdam, The Netherlands. 2. Department of Paediatric Radiology, Sophia Children's Hospital, Erasmus University Medical Centre, Rotterdam, The Netherlands. 3. Department of Emergency Medicine, Isala hospital, Zwolle, The Netherlands. 4. Department of Radiology, Albert Schweitzer Hospital, Dordrecht, The Netherlands. 5. Department of Paediatric Gastroenterology, Albert Schweitzer Hospital, Dordrecht, The Netherlands. 6. Department of Radiology, Catharina Hospital, Eindhoven, The Netherlands. 7. Department of Surgery, Medical Centre Leeuwarden, Leeuwarden, The Netherlands. 8. Department of Paediatric Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands. 9. Department of Radiology, Emma Children's Hospital - Academic Medical Centre Amsterdam, The Netherlands. 10. Department of Paediatric Surgery, Emma Children's Hospital - Academic Medical Centre Amsterdam, The Netherlands. Electronic address: r.bakx@amc.uva.nl.
Abstract
BACKGROUND: There is a lack of studies addressing the occurrence of negative intraoperative findings (that is the absence of intussusception) after an unsuccessful hydrostatic reduction of an ileocolic intussusception. The aim of this study is to determine the incidence of negative intraoperative findings after unsuccessful hydrostatic reduction of ileocolic intussusception. METHODS: We conducted a multicentre retrospective study of all children aged 0-18 years treated for ileocolic intussusception from January 1, 2010 to December 31, 2015 in 9 Dutch hospitals. Primary outcome measure was the percentage of children without an intussusception during surgical exploration after unsuccessful hydrostatic reduction. RESULTS: In the study period 436 patients were diagnosed with an ileocolic intussusception. Of these, 408 patients underwent hydrostatic reduction of an ileocolic intussusception. 112 patients (27.5%) underwent surgery after an unsuccessful hydrostatic reduction. In 13 (11.6%) patients no intraoperative evidence of intussusception was found. Patients who underwent surgical intervention after unsuccessful hydrostatic reduction were significantly younger than patients who had a successful hydrostatic reduction; there was no gender difference. CONCLUSION: A substantial number of children (11.6%) underwent a laparotomy after unsuccessful hydrostatic reduction in whom no intussusception was found intraoperatively. We suggest initiating laparoscopy instead of laparotomy when surgery is necessary. LEVEL OF EVIDENCE: Level II.
BACKGROUND: There is a lack of studies addressing the occurrence of negative intraoperative findings (that is the absence of intussusception) after an unsuccessful hydrostatic reduction of an ileocolic intussusception. The aim of this study is to determine the incidence of negative intraoperative findings after unsuccessful hydrostatic reduction of ileocolic intussusception. METHODS: We conducted a multicentre retrospective study of all children aged 0-18 years treated for ileocolic intussusception from January 1, 2010 to December 31, 2015 in 9 Dutch hospitals. Primary outcome measure was the percentage of children without an intussusception during surgical exploration after unsuccessful hydrostatic reduction. RESULTS: In the study period 436 patients were diagnosed with an ileocolic intussusception. Of these, 408 patients underwent hydrostatic reduction of an ileocolic intussusception. 112 patients (27.5%) underwent surgery after an unsuccessful hydrostatic reduction. In 13 (11.6%) patients no intraoperative evidence of intussusception was found. Patients who underwent surgical intervention after unsuccessful hydrostatic reduction were significantly younger than patients who had a successful hydrostatic reduction; there was no gender difference. CONCLUSION: A substantial number of children (11.6%) underwent a laparotomy after unsuccessful hydrostatic reduction in whom no intussusception was found intraoperatively. We suggest initiating laparoscopy instead of laparotomy when surgery is necessary. LEVEL OF EVIDENCE: Level II.
Authors: Tae Yeon Jeon; Sung-Hoon Moon; Hae Won Kim; Kyunga Kim; So-Young Yoo; Yon Ho Choe; Sanghoon Lee; Jeong-Meen Seo; Ji Hye Kim Journal: Quant Imaging Med Surg Date: 2022-07