Predictors for bowel resection and the presence of a pathological lead point for
operated childhood intussusception: A multi-center study.
J Pediatr Surg 2016;
51:1998-2000. [PMID:
27666006 DOI:
10.1016/j.jpedsurg.2016.09.033]
[Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 09/12/2016] [Indexed: 12/16/2022]
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.
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