Laparoscopic versus open management of adult intussusception

BACKGROUND: Laparotomy has been the traditional approach for the treatment of adult intussusception. The aim of the present study was to compare the short-term clinical outcomes of laparoscopic surgery to those of open surgery in adult patients with intussusception.

METHODS: We retrospectively reviewed data of all adult patients with intussusception admitted to our hospital between 2007 and 2017. The patients' characteristics, presentation, operation details, postoperative outcomes and pathology were analyzed. Comparisons were made between the laparoscopic and open surgery procedures performed during the study period.

RESULTS: Seventeen open and 20 laparoscopic-assisted resections were performed. No significant differences were found between the two groups for the following parameters: age (45.3 ± 16.8 vs. 54.9 ± 19.1, p = 0.160); gender (41 vs. 60% males, p = 0.330); American Society of Anesthesiologists score (p = 0.609); history of cardiovascular disease (5.9% vs. 5.6%, p = 0.950), COPD/asthma (0% vs. 5.6%, p = 0.950), diabetes (11.8% vs. 11.1%, p = 0.950), and renal impairment (5.9% vs. 0%, p = 0.486); body mass index (20.6 vs. 21.9, p = 0.433); timing of presentation (p = 1.000); type of intussusception (p = 0.658); type of procedures (p = 0.446); operative time (173.7 ± 45.4 vs. 191.5 ± 43.9, p = 0.329); and length of postoperative stay (6.7 ± 5.4 vs. 4.5 ± 1.1 days, p = 0.153). However, the open surgery group had fewer patients with hypertension (17.6% vs. 61.1%, p = 0.009) and demonstrated a delayed oral intake (4.0 ± 1.7 days vs. 2.5 ± 0.7 days, p = 0.010) and a higher comprehensive complication index (11.5 ± 27.1 vs. 0, p = 0.038).

CONCLUSIONS: The laparoscopic approach was associated with earlier oral intake and a lower comprehensive complication index. It is a safe and feasible technique that confers the advantages of minimally invasive surgery. It can be considered the preferred surgical option when the surgical expertise is available.