A retrospective study about incidental appendectomy during the laparoscopic treatment of intussusception

Retrospective cohort study of minimally invasive surgical approaches for pediatric intussusception

Intussusception is a common pediatric emergency that causes significant morbidity and mortality, particularly in low- to middle-income countries. The laparoscopic management of intussusception following failed non-invasive methods remains a topic of debate. This study aims to evaluate the long-term outcomes of minimally invasive approaches for intussusception. A retrospective analysis was conducted on patients who underwent minimally invasive surgery for intussusception between January 2016 and December 2020 at our institution. Data on patient demographics, pre-operative and intra-operative variables, immediate postoperative complications, length of hospital stay, and long-term results were collected. A total of 181 patients underwent minimally invasive surgery, including 117 boys (64.6%) and 64 girls (35.4%), with a median age of 8 months (range: 2-134). The median hospital stay was 4 days. Thirty-nine patients underwent trans-umbilical mini-open reduction (MO group), while 142 had laparoscopic exploration after failed air enema reduction. Among them, 40 had successful laparoscopic reduction (LAP group), and 102 required conversion to laparoscopic-assisted mini-open reduction (LAMO group). No intra-operative or immediate postoperative complications were observed. Recurrence occurred in 13 patients (7.2%) after a median follow-up of 43 months, with 6 patients (3.3%) requiring laparoscopic adhesiolysis due to bowel adhesions. In conclusion, minimally invasive surgery for intussusception is a safe and feasible approach with excellent long-term outcomes.

Benign or by Chance: A Case Report on Incidental Appendectomy Revealing a Neuroendocrine Tumor During Traumatic Exploratory Laparotomy

Incidental appendectomies (IAs) are often performed in laparotomies to prevent future complications caused by the buildup of scar tissue. Although neoplastic findings are rare, all appendectomy specimens should be sent for histopathological analysis. We present the case of a 38-year-old man found to have an appendiceal neuroendocrine tumor (NET) after receiving an IA secondary to a traumatic rectal perforation requiring exploratory laparotomy. Well-differentiated NETs isolated to the appendix have an excellent prognosis. Appendectomies are considered curative for NETs smaller than 2 cm that have not metastasized beyond the appendix. Appendiceal NETs are capable of secreting vasoactive substances and, therefore, causing carcinoid syndrome. However, the progression to carcinoid syndrome generally coincides with metastasis to the liver, indicating a poor prognosis. While histopathological analysis of appendectomy specimens rarely yields atypical findings, this analysis is crucial to ensure that the proper treatment is selected based on tumor progression in an appendectomy specimen staining positive for somatotropin and chromogranin.