Okumus Mustafa, Emektar Ali
a Department of Pediatric Surgery , Yeniyüzyıl University, Faculty ofMedicine, Gaziosmanpaşa Hospital and Bahat Hospital , Istanbul , Turkey.
b Department of Radiology , Bahat Hospital , Istanbul , Turkey.
Acta Chir Belg. 2019 Jun;119(3):162-165. doi: 10.1080/00015458.2018.1487190. Epub 2018 Jun 27.
The success of non-operative reduction methods is extremely high in pediatric intussusceptions. Recurrent intussusceptions are also well-known entities in the pediatric age group after non-operative and operative reduction. Historical recommendations include a 24- to 48-h observation period after reduction. This situation often leads to unnecessary time loss. We aimed to show that early discharge does not pose a significant risk.
The medical records of patients who presented to our hospital between January 2008 and June 2017 were retrospectively reviewed. Data collected included age, clinical presentation, procedural information, surgical intervention, hospital stay, and presence of recurrence.
A total of 62 patients were included the study. Non-operative reduction was successful in 58 of 62 patients (93.5%). Four patients with failed non-operative reduction underwent subsequent surgical procedures. All patients were allowed oral intake within 2-4 h (mean: 2.6 h) after successful non-operative reduction and discharged within 5-8 h (mean: 6.2 h) after reduction. There were five episodes of recurrence and none occurred in the first 48 h after reduction. All recurrences were treated with non-operative reduction as in the first attempt. There were no problems detected in short- or long-term follow-ups.
Pneumatic reduction is a safe and effective method in pediatric intussusception. If one is confident about treatment success, patients can be discharged without a long observation period. Early discharge is also cost-effective and reduces time loss.
非手术复位方法在小儿肠套叠中的成功率极高。复发性肠套叠在小儿年龄组中也是非手术和手术复位后常见的情况。以往的建议包括复位后观察24至48小时。这种情况常常导致不必要的时间浪费。我们旨在表明早期出院不会带来重大风险。
回顾性分析2008年1月至2017年6月期间我院收治患者的病历。收集的数据包括年龄、临床表现、操作信息、手术干预、住院时间和复发情况。
本研究共纳入62例患者。62例患者中有58例非手术复位成功（93.5%）。4例非手术复位失败的患者随后接受了手术治疗。所有患者在非手术复位成功后2至4小时内（平均：2.6小时）开始经口进食，并在复位后5至8小时内（平均：6.2小时）出院。有5例复发，且均未在复位后的前48小时内发生。所有复发均如首次尝试一样采用非手术复位治疗。短期和长期随访均未发现问题。
空气灌肠复位是小儿肠套叠的一种安全有效的方法。如果对治疗成功有信心，患者无需长时间观察即可出院。早期出院也具有成本效益，并减少了时间浪费。
