Carol W Y Wong1, Shuguang Jin2, Jie Chen3, Paul K H Tam1, Kenneth K Y Wong4. 1. Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong. 2. Department of Surgery, West China Center of Medical Sciences of Sichuan University, Sichuan, China. 3. Department of Surgery, Xin Hau Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. 4. Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong. Electronic address: kkywong@hku.hk.
Abstract
BACKGROUND: Intussusception may require bowel resection. Here, we aim to define factors that predict the need of bowel resection and the presence of pathological lead point. METHODS: A retrospective review was taken from three tertiary centers for all operated intussusception patients from January 2010 to December 2014. Patient demographics were recorded. Statistical analysis was performed, and risk factors were derived by binary logistic regression. RESULTS: Five thousand ninety-six patients were treated for intussusception with 73 (57 male, 16 female) operated. The median age was 23.2months, and median duration of symptoms was 2days. Twenty-eight patients (38.4%) required bowel resection. Logistic regression demonstrated that older age (p=0.018) and longer duration of symptoms (p=0.009) were associated with bowel resection. Furthermore, older age was a predictive factor for the presence of a pathological lead point (p=0.01). A palpable abdominal mass was also found to be associated with the need of bowel resection (risk ratio 2.3) and the presence of pathological lead point (risk ratio 2.3) independently. CONCLUSION: Older age at presentation and a longer duration of symptoms are positive predictors for the need of bowel resection in intussusception. The presence of a pathological lead point is more likely in older children. LEVEL OF EVIDENCE: Case series with no comparison group - Level IV. Copyright Â
BACKGROUND: Intussusception may require bowel resection. Here, we aim to define factors that predict the need of bowel resection and the presence of pathological lead point. METHODS: A retrospective review was taken from three tertiary centers for all operated intussusception patients from January 2010 to December 2014. Patient demographics were recorded. Statistical analysis was performed, and risk factors were derived by binary logistic regression. RESULTS: Five thousand ninety-six patients were treated for intussusception with 73 (57 male, 16 female) operated. The median age was 23.2months, and median duration of symptoms was 2days. Twenty-eight patients (38.4%) required bowel resection. Logistic regression demonstrated that older age (p=0.018) and longer duration of symptoms (p=0.009) were associated with bowel resection. Furthermore, older age was a predictive factor for the presence of a pathological lead point (p=0.01). A palpable abdominal mass was also found to be associated with the need of bowel resection (risk ratio 2.3) and the presence of pathological lead point (risk ratio 2.3) independently. CONCLUSION: Older age at presentation and a longer duration of symptoms are positive predictors for the need of bowel resection in intussusception. The presence of a pathological lead point is more likely in older children. LEVEL OF EVIDENCE: Case series with no comparison group - Level IV. Copyright Â
Authors: Sharon Cox; Aletha Withers; Marion Arnold; Milind Chitnis; Corné de Vos; Mari Kirsten; Susanna M le Grange; Jerome Loveland; Sello Machaea; Ashwini Maharaj; Shabir A Madhi; Jacqueline E Tate; Umesh D Parashar; Michelle J Groome Journal: Pediatr Surg Int Date: 2021-07-02 Impact factor: 1.827