Journal of pediatric surgery · 2026
Multicenter analysis of time interval to intussusception reduction: Success and complication rates.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Strubel Naomi A, Barton Katherine, Baran Timothy M, Wakeman Derek, Chaturvedi Apeksha, Diaz Eric, Jha Sujit, John Susan D, Lala Shailee V, Leland Kristin, Silva Cicero T, Thomas Richard D, Williams Jennifer L, Chess Mitchell A
Аннотация
INTRODUCTION: Recent evidence shows that a 6-8 h interval between diagnosis and reduction of ileocolic intussusception does not negatively impact clinical outcomes. The goal of this study is to investigate the safe interval between diagnosis and non-operative reduction attempt for ileocolic intussusception.
METHODS: This multicenter, retrospective review assessed enema reduction success and patient complications in ileocolic intussusception without lead point in patients aged 0-4 years over an 8 year period (2014-2021) in nine tertiary care institutions with subspecialty pediatric services.
RESULTS: Analysis of 1412 incidences of ileocolic intussusception (mean [SD] age, 19.2 [13.8] months; 61.8 % male) was performed. Most reductions, 96.3 %, were attempted within 8 h of imaging diagnosis. Reduction success at different intervals from diagnosis was relatively uniform: % success at time from diagnosis [N]: <8 h, 87.4 % [1359]; 8-12 h, 87.9 % [33]; >12 h, 90 % [20]. Success declined to 66.7 % > 24 h after diagnosis [3 cases]. Surgical reduction was performed in 12.7 % of cases [179]; of these, 27.9 % [50] were complicated, requiring bowel repair and/or resection. Rates of surgery (12.7 % < 8 h, 12.1 % 8-12 h, 10.0 % > 12 h, p = 0.94) and the rate of complicated intussusception (27.7 % < 8 h, 25 % 8-12 h, 50 % > 12 h [1 of 2 patients], p = 0.78) did not significantly increase with increasing time after diagnosis.
CONCLUSIONS: Success rate of enema reduction of ileocolic intussusception is maintained out to 8 h from diagnosis, without increased complications. These findings support the cautious modification of the standard of care for ileocolic intussusception in appropriately selected patients.
METHODS: This multicenter, retrospective review assessed enema reduction success and patient complications in ileocolic intussusception without lead point in patients aged 0-4 years over an 8 year period (2014-2021) in nine tertiary care institutions with subspecialty pediatric services.
RESULTS: Analysis of 1412 incidences of ileocolic intussusception (mean [SD] age, 19.2 [13.8] months; 61.8 % male) was performed. Most reductions, 96.3 %, were attempted within 8 h of imaging diagnosis. Reduction success at different intervals from diagnosis was relatively uniform: % success at time from diagnosis [N]: <8 h, 87.4 % [1359]; 8-12 h, 87.9 % [33]; >12 h, 90 % [20]. Success declined to 66.7 % > 24 h after diagnosis [3 cases]. Surgical reduction was performed in 12.7 % of cases [179]; of these, 27.9 % [50] were complicated, requiring bowel repair and/or resection. Rates of surgery (12.7 % < 8 h, 12.1 % 8-12 h, 10.0 % > 12 h, p = 0.94) and the rate of complicated intussusception (27.7 % < 8 h, 25 % 8-12 h, 50 % > 12 h [1 of 2 patients], p = 0.78) did not significantly increase with increasing time after diagnosis.
CONCLUSIONS: Success rate of enema reduction of ileocolic intussusception is maintained out to 8 h from diagnosis, without increased complications. These findings support the cautious modification of the standard of care for ileocolic intussusception in appropriately selected patients.