Is there a reduction of post-operative adhesion formation in pediatric age after laparoscopy compared with open surgery ?

Background and Purpose: Intraperitoneal adhesions are the most frequent cause of recurrent abdominal pain and intestinal obstruction after traditional open abdominal surgery. We sought to determine the true incidence of adhesion formation after laparotomy and laparoscopy in children. Patients and Methods: We examined the clinical data of 55 children operated on laparoscopically in our department from 1996 to 1998. All of these children had already undergone surgery: 27 had had laparoscopy and 28 a laparotomy. Results: Of the 27 postlaparoscopy patients, only 5 (18%) presented adhesions, whereas 24 of the 28 patients (85%) who had undergone laparotomy were found to have adhesions. In this latter group, seven presented with recurrent abdominal pain, which was the indication for the second procedure. One of these patients had a partial intestinal obstruction. In the remaining 47 patients, the laparoscopy was not occasioned by abdominal pain or obstruction. Conclusions: These preliminary results and a review of the literature suggest that laparoscopy is considerably less likely than laparotomy to induce adhesion formation in pediatric patients.