[Recurrence of uncomplicated intestinal intussusception. Can it be treated as an outpatient?]

Autor:	Espinoza Vega ML; Servicio de Cirugía Pediátrica. Hospital Infantil Universitario Niño Jesús. Madrid., Martín Rivada A; Servicio de Pediatría. Hospital Infantil Universitario Niño Jesús. Madrid., Rico Espiñeira C; Servicio de Cirugía Pediátrica. Hospital Infantil Universitario Niño Jesús. Madrid., De Lucio Rodríguez M; Servicio de Cirugía Pediátrica. Hospital Infantil Universitario Niño Jesús. Madrid., Guillén Redondo P; Servicio de Cirugía Pediátrica. Hospital Infantil Universitario Niño Jesús. Madrid., Luis Huertas AL; Servicio de Cirugía Pediátrica. Hospital Infantil Universitario Niño Jesús. Madrid., Souto Romero H; Servicio de Cirugía Pediátrica. Hospital Infantil Universitario Niño Jesús. Madrid., Espinosa Góngora R; Servicio de Cirugía Pediátrica. Hospital Infantil Universitario Niño Jesús. Madrid., Ollero Fresno JC; Servicio de Cirugía Pediátrica. Hospital Infantil Universitario Niño Jesús. Madrid.
Jazyk:	Spanish; Castilian
Zdroj:	Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica [Cir Pediatr] 2017 Apr 20; Vol. 30 (2), pp. 95-99. Date of Electronic Publication: 2017 Apr 20.
Abstrakt:	Objectives: To estimate the recurrence rate of intussusception after successful enema reduction and to analyze the costs of hospital admission with the current management of this pathology. Material and Methods: A retrospective study over 5 years of 97 patients with confirmed diagnosis of intussusception was undertaken. Medical records were evaluated for patient demographic, clinical and radiological data. Patients with enema-reduced intussusception were selected and data respecting to timing and outcome of recurrences, and length of stay were analyzed. Recurrence was defined as a new episode of intussusception within 72 hours of the initial presentation. Costs were calculated using hospital-specific data. Results: During the study period there were 81/97 children with successful enema reduction. Mean length of stay was 35 hours in the conservative treatment group. There were 8 episodes of recurrence, 5 of them within the first 24 hours (6.17%), for an overall recurrence rate of 9.88%. 7 children were treated by repeated enema and only one patient needed surgery for persistent illness. Assuming the overall recurrence rate of 9.88%, it would require hospitalizing 16 patients to identify a single recurrence with a cost of 1,723.75 € per patient. Conclusions: Given the low recurrence rate for enema-reduced intussusception and the possibility of repeated enema for their treatment in most of recurrences, we strongly advocated for the outpatient management as a safe and cost-effective alternative.
Databáze:	MEDLINE
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