Hannon Edward John, Allan Rosemary Anne, Negus April Samantha, Murphy Feilim, Okoye Bruce Obi
Department of Paediatric Surgery, St George's Hospital, Tooting, UK.
Pediatr Surg Int. 2013 Aug;29(8):805-9. doi: 10.1007/s00383-013-3328-2. Epub 2013 Jun 4.
In the UK, air enema reduction of intussusception is predominantly performed by consultant radiologists. At our institution, it is usually performed by a team involving radiology and surgical registrars. The purpose of this study was to assess who performs air enemas in the UK and the efficacy and safety of our registrar-led service.
A telephone survey of paediatric surgical centres in the UK was performed asking who performs air enema in these institutions. Following this, a retrospective review of all air enemas at our institution between January 2005 and 2011 was performed. Cases were identified from radiology databases and reviewed for grade of radiologist, perforation and outcome.
At all 25 centres, consultant radiologists performed air enemas. At our institution 145 enemas were performed in 6 years. 141 were analysed (54 girls, 87 boys). Median age was 9 months (range 3-107 months). 82 % were performed by the registrar-only team. Over 6 years the registrar-led reduction rate was 77.5 % and in the last 3 years 84 %. The perforation rate was 0.9 %.
A paediatric surgical registrar-led service for air enema reduction can be safe and effective ensuring a team approach is adopted, equipment is efficient and a strict protocol is applied.
在英国，肠套叠空气灌肠复位术主要由放射科顾问医师实施。在我们机构，通常由放射科和外科住院医师组成的团队来进行。本研究的目的是评估在英国谁实施空气灌肠术以及我们由住院医师主导的服务的有效性和安全性。
对英国的儿科外科中心进行电话调查，询问这些机构中谁实施空气灌肠术。在此之后，对我们机构在2005年1月至2011年期间所有的空气灌肠术进行回顾性研究。从放射科数据库中识别病例，并对放射科医师级别、穿孔情况和结果进行评估。
在所有25个中心，均由放射科顾问医师实施空气灌肠术。在我们机构，6年中共进行了145次灌肠术。分析了141例（54名女孩，87名男孩）。中位年龄为9个月（范围3 - 107个月）。82％由仅住院医师组成的团队实施。6年中，由住院医师主导的复位率为77.5％，最近3年为84％。穿孔率为0.9％。
由儿科外科住院医师主导的空气灌肠复位服务可以是安全有效的，前提是采用团队协作方式、设备高效且严格执行方案。
