Laparoscopy in post operative adhesive intestinal obstruction in children, is it a good option?

Postoperative adhesive small bowel obstruction (ASBO) is one of the major complications of abdominal surgery in children.(1, 2) Although the incidence of postoperative ASBO varies according to the type of operation performed, its incidence in children has been estimated to be between 1 and 5%.(3, 4) Surgical intervention is frequently necessary (in 35–45% of cases) to mitigate the risk of complications such as intestinal perforation and gangrene. Objectives: our study aims to assess the efficacy of the laparoscopic approach in postoperative adhesive intestinal obstruction in children, focusing on postoperative recovery, pain management, and cosmetic outcomes. Patients and methods: A total of 28 children exhibiting signs and symptoms indicative of intestinal obstruction (including bilious and non-bilious vomiting, abdominal distension, tenderness, and absence of stool passage) were enrolled. Additionally, an erect X-ray of the abdomen and pelvis was performed to visualize air-fluid levels. According to our institutional protocol, all children were admitted to our unit and placed on oral gastrograffin therapy while being kept nil by mouth; a nasogastric tube was inserted. Daily erect X-rays were conducted to monitor progress. Results: Twenty patients failed to respond to conservative treatment and required exploration. Following a 48-hour period with no clinical or radiological improvement, laparoscopic exploration was pursued. Conclusion: we sum up that the use of laparoscopy in post operative adhesive intestinal obstruction in children is safe and effective regarding the operative time, intraoperative complications, postoperative hospital stay and recovery.