The incidence of negative intraoperative findings after unsuccessful hydrostatic reduction of ileocolic intussusception in children: A retrospective analysis

Maadrika M. N. P. Kanglie, Nanko de Graaf, Femke Beije, Elise M. J. Brouwers, Sabine D. M. Theuns-Valks, Frits H. Jansen, Diederick B. W. de Roy van Zuidewijn, Bas Verhoeven, Rick R. Van Rijn, Roel Bakx*, J. H. Allema, J. L. M. Bruggink, M. Y. Van Herwaarden, H. C. Holscher, W. M. Klein, R. A. J. Nievelstein, S. G. F. Robben, J. van Schuppen, J. I. L. M. Verbeke, R. WijnenDutch Intussusception Group

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

10 Citations (Web of Science)

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. (C) 2018 Elsevier Inc. All rights reserved.

Original languageEnglish
Pages (from-to)500-506
Number of pages7
JournalJournal of Pediatric Surgery
Volume54
Issue number3
DOIs
Publication statusPublished - Mar 2019

Keywords

  • Intussusception
  • Hydrostatic reduction
  • Negative intraoperative findings
  • Pediatric surgery
  • Laparotomy
  • Laparoscopy
  • PATHOLOGICAL LEAD POINTS
  • MANAGEMENT
  • ENEMA
  • LAPAROSCOPY
  • METAANALYSIS
  • AIR

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