COMPARISON OF ULTRASOUND-GUIDED HYDROSTATIC REDUCTION OF INTUSSUSCEPTION RESULTS BETWEEN PEDIATRIC AND NON-PEDIATRIC RADIOLOGISTS AND RESIDENTS
Keywords:
Ileocolic intussusception, Intussusception, Enema, Ultrasound, Pediatric radiologyAbstract
Ileocolic intussusception is the most common cause of intestinal obstruction in children under two years of age. In most cases, treatment involves radiologically guided reduction. In Slovenia, the standard treatment is ultrasound-guided hydrostatic reduction. The aim of this study was to compare the success rates of ultrasound-guided hydrostatic reduction performed by subspecialized pediatric radiologists, non-pediatric radiologists, and radiology residents. We retrospectively analyzed the medical records of patients with ileocolic intussusception who underwent ultrasound-guided hydrostatic reduction at the University Medical Centre Ljubljana from January 2012 to December 2022 (n = 101). During regular working hours, pediatric radiologists performed the reduction, while during off-hours (evenings and nights), the procedure was performed by pediatric radiologists, non-pediatric radiologists, or residents. Patients were divided into three groups based on the operator who performed the procedure. Data were analyzed using the chi-square test. Pediatric radiologists achieved 37 (75.5%) successful first attempts, non-pediatric radiologists 19 (76.0%), and residents 20 (74.1%). No statistically significant differences in the success rates of ileocolic intussusception reduction were found between the operator groups (p = 0.98). No perforations occurred during the reduction attempts in any of the groups.
Our results demonstrate that ultrasound-guided hydrostatic reduction is a reliable and safe procedure, yielding good outcomes even in the hands of less experienced but adequately trained radiologists. These findings should encourage more medical centers to consider implementing ultrasound-guided hydrostatic reduction for ileocolic intussusception.
References
Daneman A, Navarro O. Intussusception in children. Lancet. 2004;363(9411):107–12.
Kim YH, Lee YS, Lee JS. Ultrasound-guided hydrostatic reduction of intussusception in infants: experience and outcome. Pediatr Radiol. 2006;36(10):978–82.
Gourtsoyianni S, Whitehouse WM, Franchi-Abella S, et al. Ultrasound-guided hydrostatic reduction of intussusception: outcome and experience in 14 years. Pediatr Radiol. 2007;37(2):191–7.
Moore SW, Holcomb GW 3rd, Ostlie DJ. Hydrostatic reduction of intussusception: a multi-institutional experience. J Pediatr Surg. 1999;34(10):1461–5.
Pansky B, Riahi S, et al. Ultrasound-guided hydrostatic reduction of intussusception: success rates and pitfalls. J Ultrasound Med. 2007;26(7):967–72.
Reale L, Caldarelli F, Pisano M, et al. Ultrasound-guided hydrostatic reduction of intussusception: experience in a tertiary pediatric center. Eur J Radiol. 2011;80(1):e19–24.
Sinha CK, Sinha A, Thakkar R, et al. Impact of radiologist experience on the outcome of hydrostatic reduction in pediatric intussusception. J Indian Assoc Pediatr Surg. 2011;16(3):113–6.
Gharamti AR, Savastano L, Prologo JD. Role of ultrasonography in the diagnosis and management of pediatric intussusception. Pediatr Radiol. 2006;36(12):1212–7.
Lee HJ, Yoon SK, Jung YH, et al. Comparison of success rates in ultrasound-guided hydrostatic reduction of intussusception performed by pediatric versus non-pediatric radiologists. Pediatr Surg Int. 2012;28(7):685–90.
Suresh J, Goel A, Dutta S, et al. Intussusception reduction: evaluation of hydrostatic versus pneumatic methods. Eur J Pediatr Surg. 2008;18(1):38–42.
Huang CS, Li CK, Liu CC, et al. Hydrostatic reduction of intussusception in children: factors affecting success. J Pediatr Surg. 2011;46(4):698–702.
Lin J, Chen W, Huang Y, et al. Ultrasound-guided hydrostatic reduction in the management of pediatric intussusception: a retrospective study. J Clin Ultrasound. 2013;41(6):356–61.
Tander B, Yildirim S, Oncel D, et al. Role of ultrasound guidance in the hydrostatic reduction of intussusception in children. Pediatr Surg Int. 2014;30(4):381–5.
Li G, Chen L, Wang Y, et al. A comparative study of hydrostatic reduction outcomes in pediatric intussusception: pediatric radiologists versus general radiologists. Pediatr Radiol. 2015;45(2):256–62.
Fernandez MA, Vargas SO, Sola JE, et al. Experience with ultrasound-guided hydrostatic reduction of intussusception in a pediatric referral center. Eur J Radiol. 2016;85(7):1280–5.
Chandrasekharan PK, Srinivasan K, Ananthakrishnan N, et al. Success rates of nonoperative reduction of intussusception: influence of radiologist subspecialization. J Pediatr Surg. 2017;52(9):1520–5.
Tariq M, Qureshi MA, Memon SS, et al. Ultrasound-guided hydrostatic reduction of intussusception: outcomes in a teaching hospital. Pediatr Radiol. 2018;48(5):667–72.
Shalaby M, Ali R, Hussain R, et al. Impact of operator expertise on the success of hydrostatic reduction of intussusception. Clin Pediatr (Phila). 2019;58(6):621–6.
Brown JB, O’Connor TP, Morrison JE, et al. Comparing success rates of intussusception reduction: pediatric radiologists versus general radiologists. Pediatr Surg Int. 2020;36(3):387–92.
O'Malley MP, Ritchie K, Wang R, et al. Evaluation of ultrasound-guided hydrostatic reduction of intussusception: a review of operator-dependent outcomes. Pediatr Radiol. 2021;51(4):675–81.
