Multicenter analysis of time interval to intussusception reduction: Success and complication rates

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Radiology

Background:

• Ileocolic intussusception is a common pediatric surgical emergency.
• Previous studies suggest a 6-8 hour window is safe for reduction.
• Optimal timing for non-operative reduction remains under investigation.

Purpose of the Study:

• To determine the safe and effective interval between diagnosis and non-operative reduction for ileocolic intussusception.
• To evaluate the impact of time from diagnosis to reduction on success rates and complications.

Main Methods:

• Multicenter retrospective review of 1412 cases of ileocolic intussusception (0-4 years).
• Data collected from 2014-2021 across nine tertiary care institutions.
• Analysis of enema reduction success and surgical complications based on time from diagnosis.

Main Results:

• Reduction success rates were uniform up to 8 hours (87.4%), with a slight decline after 24 hours (66.7%).
• Surgical intervention rates (12.7%) and complication rates (27.9%) did not significantly increase with time from diagnosis up to 12 hours.
• No significant difference in surgical or complicated intussusception rates was observed based on the interval from diagnosis to reduction.

Conclusions:

• Enema reduction success for ileocolic intussusception is maintained up to 8 hours post-diagnosis without increased complications.
• These findings support considering a modified standard of care for selected patients.
• Extending the reduction window may be safe and effective in certain cases.