Pneumatic versus hydrostatic reduction in the treatment of intussusception in children

Ali, Ahmad M.; Sheir, Hesham; Saied, Basem; Wafa, Tamer; El-Ghazaly, Mohamed

doi:10.1097/01.xps.0000516209.20838.56

Cited by 6 publications

(12 citation statements)

References 16 publications

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“…A randomized controlled trial (RCT) in 2018 of 124 pediatric intussusception cases in China showed that the success rate of UGHR (96.77%) was higher than FGAR (83.87%), which demonstrated that UGHR is more effective than FGAR [6]. A prospective cohort study in 2017 of 80 pediatric intussusception cases in Egypt showed that the success rates of FGAR and UGHR were equal (82.5%), which demonstrated a similar effectiveness of UGHR and FGAR [4]. Both of these two studies had the disadvantage of a small number of cases (less than 200 cases).…”

Section: Resultsmentioning

confidence: 99%

“…Currently, ultrasound-guided hydrostatic reduction (UGHR) and uoroscopy-guided air reduction (FGAR) are the most commonly used nonsurgical treatment methods [2,3], the indications and contraindications of which are basically the same. There are only a few studies comparing the effectiveness and safety of UGHR and FGAR in the literature [4][5][6][7], and no clear consensus has been reached regarding the optimal reduction strategy. Some studies demonstrated a higher success rate of UGHR [5,6], while some studies demonstrated a higher success rate of FGAR [4,7].…”

Section: Introductionmentioning

confidence: 99%

“…There are only a few studies comparing the effectiveness and safety of UGHR and FGAR in the literature [4][5][6][7], and no clear consensus has been reached regarding the optimal reduction strategy. Some studies demonstrated a higher success rate of UGHR [5,6], while some studies demonstrated a higher success rate of FGAR [4,7]. Till now, there was no multi-center prospective study for UGHR and FGAR in the treatment of pediatric intussusception in the world.…”

Section: Introductionmentioning

confidence: 99%

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Ultrasound-Guided Hydrostatic Reduction Versus Fluoroscopy-Guided Air Reduction for Pediatric Intussusception: A Multi-Center, Prospective, Cohort Study

Liu

Tang

et al. 2020

Preprint

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Background：Intussusception is the most common abdominal emergency in children. The first line treatment of uncomplicated pediatric intussusception is enema reduction. Until now, there have been no multi-center studies comparing the effectiveness and safety of UGHR and FGAR in the treatment of pediatric intussusception. The aim of this study was to compare the effectiveness and safety of the two most commonly used enema methods of pediatric intussusception: Ultrasound-guided hydrostatic reduction (UGHR) and Fluoroscopy-guided air reduction (FGAR).Methods: From November 1, 2017 to October 31, 2018, we conducted a multi-center, prospective, cohort study. Children diagnosed with intussusception in four large Children’s Medical Centers in China were divided into UGHR and FGAR groups. Stratified analysis and subgroup analysis were used for further comparison. The success and recurrence rates were used to evaluate the effectiveness of enema reduction. The perforation rate was used to evaluate the safety of enema reduction.Results: A total of 2,124 cases met the inclusion criteria (UGHR group: 1119 cases; FGAR group: 1005 cases). The success and recurrence rates in the UGHR group were higher than in the FGAR group (95.80%, 9.28% vs. 93.13%, 10.65%) (P<0.05, P>0.05), respectively. The perforation rate in the UGHR group was 0.36% compared with 0.30% in the FGAR group (P>0.05). Subgroup analysis showed the success rates in the UGHR group were higher than in the FGAR group of patients with onset time between 12h and 24h (95.56% vs 90.57%) (P<0.05). Of patients aged 4 to 24 months, the success rates in the UGHR group were also higher than in the FGAR group (95.77% vs 91.60%) (P<0.05). Stratified analysis showed the success rates in the UGHR group were higher than in the FGAR group in patients with the symptom of bloody stool (91.91% vs 85.38%) (P<0.05).Conclusions: UGHR and FGAR are safe, nonsurgical treatment methods for acute pediatric intussusception. UGHR is superior to FGAR, no radiation risk, its success rate is higher, without a difference in perforation rate, especially for patients aged 4–24 months.Level of evidence: Level II.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Ultrasound-Guided Hydrostatic Reduction Versus Fluoroscopy-Guided Air Reduction for Pediatric Intussusception: A Multi-Center, Prospective, Cohort Study

Liu

Tang

et al. 2020

Preprint

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“…Until now, the studies including a large number of cases in the treatment of pediatric intussusception were almost retrospective single-center study with only one enema reduction method [ 10 , 15 , 16 ]. There were a few original studies comparing the effectiveness of UGHR and FGAR in the treatment of pediatric intussusception [ 4 , 6 ]. A randomized controlled trial (RCT) in 2018 of 124 pediatric intussusception cases in China showed that the success rate of UGHR (96.77%) was higher than FGAR (83.87%), which demonstrated that UGHR is more effective than FGAR [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…A randomized controlled trial (RCT) in 2018 of 124 pediatric intussusception cases in China showed that the success rate of UGHR (96.77%) was higher than FGAR (83.87%), which demonstrated that UGHR is more effective than FGAR [ 8 ]. A prospective cohort study in 2017 of 80 pediatric intussusception cases in Egypt showed that the success rates of FGAR and UGHR were equal (82.5%), which demonstrated a similar effectiveness of UGHR and FGAR [ 6 ]. Both of these two studies had the disadvantage of a small number of cases (less than 200 cases).…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-guided hydrostatic reduction versus fluoroscopy-guided air reduction for pediatric intussusception: a multi-center, prospective, cohort study

Liu

Tang

et al. 2021

World J Emerg Surg

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Background Intussusception is the most common abdominal emergency in children. The first line treatment of uncomplicated pediatric intussusception is enema reduction. Until now, there have been no multi-center studies comparing the effectiveness and safety of UGHR and FGAR in the treatment of pediatric intussusception. The aim of this study was to compare the effectiveness and safety of the two most commonly used enema methods of pediatric intussusception: ultrasound-guided hydrostatic reduction (UGHR) and fluoroscopy-guided air reduction (FGAR). Methods From November 1, 2017 to October 31, 2018, we conducted a multi-center, prospective, cohort study. Children diagnosed with intussusception in four large Children’s Medical Centers in China were divided into UGHR and FGAR groups. Stratified analysis and subgroup analysis were used for further comparison. The success and recurrence rates were used to evaluate the effectiveness of enema reduction. The perforation rate was used to evaluate the safety of enema reduction. Results A total of 2124 cases met the inclusion criteria (UGHR group: 1119 cases; FGAR group: 1005 cases). The success and recurrence rates in the UGHR group were higher than in the FGAR group (95.80%, 9.28% vs. 93.13%, 10.65%) (P < 0.05, P > 0.05), respectively. The perforation rate in the UGHR group was 0.36% compared with 0.30% in the FGAR group (P > 0.05). Subgroup analysis showed the success rates in the UGHR group were higher than in the FGAR group of patients with onset time between 12 and 24 h (95.56% vs. 90.57%) (P < 0.05). Of patients aged 4 to 24 months, the success rates in the UGHR group were also higher than in the FGAR group (95.77% vs. 91.60%) (P < 0.05). Stratified analysis showed the success rates in the UGHR group were higher than in the FGAR group in patients with the symptom of bloody stool (91.91% vs 85.38%) (P < 0.05). Conclusions UGHR and FGAR are safe, nonsurgical treatment methods for acute pediatric intussusception. UGHR is superior to FGAR, no radiation risk, its success rate is higher, without a difference in perforation rate, especially for patients aged 4–24 months. Level of evidence Level II.

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Ultrasound-guided reduction of intussusception in infants in a developing world: saline hydrostatic or pneumatic technique?

et al. 2022

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Non-operative reduction has emerged as rst line in the management of uncomplicated intussusception. The aim of this study was to compare the outcome of saline hydrostatic reduction and pneumatic reduction of intussusception in infants. MethodsThis is a prospective study of infants with uncomplicated intussusception con rmed by ultrasound over a period of twenty-one months from December, 2018 to August, 2020. Fifty-two (69.3%) out of seventyve infants underwent enema reduction under ultrasound guidance. The success rates, time to reduction and complication rates were assessed. ResultsThe success rates, between the saline hydrostatic reduction group and pneumatic reduction group, were comparable [17(65.4%) versus 19(73.1%); relative risk (RR) 0.8; 95% con dence interval (CI) 0.6-1.2; p = 0.54]. The mean time to reduction was higher in the saline hydrostatic reduction group (15.4 ± 5.1 minutes versus 10.8 ± 4.1 minutes; p = 0.003). The two groups had similar complication rates; for perforation [1(3.8%) versus 0(0.0%); RR 0.9 (CI 0.9-1.0); p = 0.31] and recurrence [2(7.7%) versus 1(3.8%); RR 0.9 (CI 0.8-1.0); p = 0.55]. ConclusionSaline hydrostatic reduction and pneumatic reduction of uncomplicated intussusception under ultrasound guidance in infants might have comparable outcomes. However, pneumatic reduction may be faster.

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Pneumatic versus hydrostatic reduction in the treatment of intussusception in children

Cited by 6 publications

References 16 publications

Ultrasound-Guided Hydrostatic Reduction Versus Fluoroscopy-Guided Air Reduction for Pediatric Intussusception: A Multi-Center, Prospective, Cohort Study

Ultrasound-Guided Hydrostatic Reduction Versus Fluoroscopy-Guided Air Reduction for Pediatric Intussusception: A Multi-Center, Prospective, Cohort Study

Ultrasound-guided hydrostatic reduction versus fluoroscopy-guided air reduction for pediatric intussusception: a multi-center, prospective, cohort study

Ultrasound-guided reduction of intussusception in infants in a developing world: saline hydrostatic or pneumatic technique?

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