Ning Li1, Qiao Bao1, Jiyan Yuan1, Xuefeng Zhou1, Jiexiong Feng1, Wen Zhang2. 1. Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China. 2. Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China. Electronic address: wzhang115@163.com.
Abstract
PURPOSE: Manual intussusception reduction can sometimes be accomplished through the existing umbilical incision after a laparoscopic attempt has failed. We compared the safety and efficacy of open transumbilical intussusception reduction (OTIR) and laparoscopic reduction (LAP). METHODS: We prospectively enrolled children diagnosed with intussusception at our hospital from June 2014 to December 2018. Clinically stable patients who failed pneumatic intussusception reduction were randomly assigned to the OTIR or LAP group. We compared reduction rates, complications, operative times, and surgery costs between the two groups. RESULTS:Fifty-one of 451 patients with an intussusception met the study criteria. In the OTIR group (n = 27), 22 intussusceptions were successfully reduced, and 5 required incision extension. The mean operative time was 47.7 ± 10.5 min, and mean surgery cost was 1259.74 ± 46.24 US dollars. In the LAP group (n = 24), 5 patients required conversion to open surgery. Three of the 5 cases were resolved by OTIR, while the other 2 needed incision extension. The mean operative time was 68.63 ± 17.13 min, and mean surgery cost was 1750.63 ± 106.98 US dollars. Severe complications did not occur in either group. CONCLUSIONS:OTIR was as safe and effective as LAP and had a shorter operative time and lower surgery cost. OTIR is a good option for intussusception reduction in children. TYPE OF STUDY: Treatment study. LEVELS OF EVIDENCE: Level I.
RCT Entities:
PURPOSE: Manual intussusception reduction can sometimes be accomplished through the existing umbilical incision after a laparoscopic attempt has failed. We compared the safety and efficacy of open transumbilical intussusception reduction (OTIR) and laparoscopic reduction (LAP). METHODS: We prospectively enrolled children diagnosed with intussusception at our hospital from June 2014 to December 2018. Clinically stable patients who failed pneumatic intussusception reduction were randomly assigned to the OTIR or LAP group. We compared reduction rates, complications, operative times, and surgery costs between the two groups. RESULTS: Fifty-one of 451 patients with an intussusception met the study criteria. In the OTIR group (n = 27), 22 intussusceptions were successfully reduced, and 5 required incision extension. The mean operative time was 47.7 ± 10.5 min, and mean surgery cost was 1259.74 ± 46.24 US dollars. In the LAP group (n = 24), 5 patients required conversion to open surgery. Three of the 5 cases were resolved by OTIR, while the other 2 needed incision extension. The mean operative time was 68.63 ± 17.13 min, and mean surgery cost was 1750.63 ± 106.98 US dollars. Severe complications did not occur in either group. CONCLUSIONS: OTIR was as safe and effective as LAP and had a shorter operative time and lower surgery cost. OTIR is a good option for intussusception reduction in children. TYPE OF STUDY: Treatment study. LEVELS OF EVIDENCE: Level I.