Modified Pneumatic Reduction Protocol for Intussusception: A Retrospective Cohort Study in an Ultrahigh Volume...

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Medical Devices

Background:

• Intussusception is a common surgical emergency in children.
• Assessing long-term outcomes of modified pneumatic reduction is crucial, especially in resource-limited settings.
• Vietnam National Hospital of Pediatrics manages a high volume of pediatric intussusception cases.

Purpose of the Study:

• To evaluate the long-term outcomes of a modified fluoroscopic-guided air-enema reduction (FGAR) protocol for intussusception.
• To determine the safety, efficacy, and recurrence rates of this modified FGAR protocol.
• To assess the feasibility of this protocol in a lower-middle-income country context.

Main Methods:

• Retrospective cohort observational study of 3562 patients undergoing modified FGAR from January 2016 to December 2017.
• Data collection included patient demographics, complication rates, and long-term recurrence incidence.
• Follow-up duration was a median of 6 years.

Main Results:

• Modified FGAR achieved a 98.7% success rate with a median procedure time of 4 minutes and a median hospital stay of 1 day.
• Complications included 43 unsuccessful reductions and 4 perforated bowels; 20 patients required ICU admission.
• Over 6 years, 5.6% of patients experienced recurrence, predominantly within the first year. Infants under 12 months had significantly higher complication rates (p < 0.05).

Conclusions:

• The modified FGAR protocol is safe, feasible, and highly effective for pediatric intussusception.
• Low complication and recurrence rates support its clinical utility.
• This protocol represents a promising treatment option for intussusception in low-to-middle-income countries.