The Advantages of Minimally Invasive Surgery for Peritoneal Adhesions in Children

Abstract

Background. Laparoscopic surgery has advantages over laparotomy. In pediatric practice, only single studies have been devoted to the leading role of laparoscopy in the treatment of peritoneal adhesions in children; randomized controlled studies have not been conducted. Objective. Our aim was to assess the advantages of laparoscopic methods of surgical treatment in patients with adhesive intestinal obstruction. Results. The main group included 58 children aged from 10 days to 18 years who underwent laparoscopic surgery. The control group included 49 children with acute adhesive intestinal obstruction. The incidence of early and late adhesive obstruction was 18 (31%) and 40 (69%) cases in the main group, 21 (42.9%) and 28 (57.1%) cases in the control group. The number of previous surgical interventions in the main group ranged from 1 to 6, in the control group – from 1 to 7. The advantages of a laparoscopic approach to the treatment of acute adhesive obstruction are confirmed by a significantly lower expression of the postoperative intestinal paresis and rapid recovery of peristalsis, early onset of enteral nutrition, and relatively rapid discharge from the hospital. It is important to note the absence of early and late postoperative complications in the laparoscopic group, especially repeated cases of intestinal obstruction (in contrast to the control group where two patients required repeated operations for obstruction). Conclusion. Laparoscopic technologies are a method of choice in the treatment of children with acute adhesive intestinal obstruction regardless of the age of patients, the extent of the adhesion process, the anatomical mechanism of intestinal obstruction.