Management of adhesive bowel obstruction in children is changed by laparoscopy.
BACKGROUND
With new advances in diagnostic and therapeutic tools, the early management of adhesive bowel obstruction has become feasible.


METHODS
In a retrospective study, 20 children with adhesive bowel obstruction were investigated to assess the possible advantages of the laparoscopic approach.


RESULTS
Laparoscopy was performed in nine children. Six of them were managed laparoscopically. Recovery was uneventful. In two children, extensive adhesions warranted elective conversion. The single complication occurred in a child with obstruction of the colon due to perforation caused by a small instrument. Eleven children underwent primary laparotomy for adhesive obstruction. Five of them had a single band and might have benefited from a laparoscopic approach.


CONCLUSIONS
Laparoscopic management of adhesive bowel obstruction in children is feasible and safe in experienced hands. Early management saves the child a great deal of discomfort and allows a quick recovery with early discharge.
van der Zee
D C
DC
Department of Pediatric Surgery, Wilhelmina Children's University Hospital, Post Office Box 85090, 3508AB Utrecht, The Netherlands.
Bax
N M
NM
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods; D007813:Laparotomy / Q000009:adverse effects; D011183:Postoperative Complications; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000150:complications