title: [Intussusception: hospital admission for risk of recurrence or early discharge?]
abstract: OBJECTIVE
  There is current debate about the need of hospitalization of patients with enema-reduced intussusception. The purpose of this study is to describe intussusception recurrence in a tertiary care children's hospital in order to evaluate the feasibility of ambulatory treatment.
  
  
  METHODS
  Retrospective review of children diagnosed with intussusception from January 2009 to December 2013, identifying early recurrences as those that occurred between 12-72 hours after successful enema reduction and comparing the results with current literature.
  
  
  RESULTS
  A total of 121 children (77 male - 44 female), with a mean age of 18,9±2,7 months and weight of 10,77±0,57 kg (CI 95%) were treated for intussusception. Enema reduction was attempted in 90,7% (n= 88) of the cases, with a success rate of 76,1% (n= 67). Early recurrence rate was 6% (n= 4), without associated complications, which is similar to recent meta-analysis results (5,4%); however, three patients required surgical exploration. Mean length of stay was 2 days for enema-reduced intussusception, which resulted in a total cost of 2,076.67 euro per patient.
  
  
  CONCLUSIONS
  The low recurrence rate and scarce risk of complications suggests that an 8 to 12 hour observation is a feasible alternative to hospital admission, which results in social advantages including family welfare as well as management costs. These results are a starting point for prospective randomized controlled trials comparing both treatment modalities.
authors.affiliation: Departamento de Cirugía Pediátrica. Hospital Universitario La Paz. Madrid.
authors.forename: M
authors.initials: M
authors.lastname: Dore Reyes
authors.affiliation: Departamento de Cirugía Pediátrica. Hospital Universitario La Paz. Madrid.
authors.forename: P
authors.initials: P
authors.lastname: Triana Junco
authors.affiliation: Departamento de Cirugía Pediátrica. Hospital Universitario La Paz. Madrid.
authors.forename: C
authors.initials: C
authors.lastname: de la Torre
authors.affiliation: Departamento de Cirugía Pediátrica. Hospital Universitario La Paz. Madrid.
authors.forename: J M
authors.initials: JM
authors.lastname: Gómez Cervantes
authors.affiliation: Departamento de Cirugía Pediátrica. Hospital Universitario La Paz. Madrid.
authors.forename: J
authors.initials: J
authors.lastname: Jiménez Gómez
authors.affiliation: Departamento de Cirugía Pediátrica. Hospital Universitario La Paz. Madrid.
authors.forename: A
authors.initials: A
authors.lastname: Sánchez Galán
authors.affiliation: Departamento de Cirugía Pediátrica. Hospital Universitario La Paz. Madrid.
authors.forename: M
authors.initials: M
authors.lastname: Romo Muñoz
authors.affiliation: Departamento de Cirugía Pediátrica. Hospital Universitario La Paz. Madrid.
authors.forename: V
authors.initials: V
authors.lastname: Amesty Morello
authors.affiliation: Departamento de Cirugía Pediátrica. Hospital Universitario La Paz. Madrid.
authors.forename: L
authors.initials: L
authors.lastname: Martínez Martínez
authors.affiliation: Departamento de Cirugía Pediátrica. Hospital Universitario La Paz. Madrid.
authors.forename: M
authors.initials: M
authors.lastname: López Santamaría
mesh_terms: D000553:Ambulatory Care; D004733:Enema / Q000706:statistics & numerical data*; D005240:Feasibility Studies; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007443:Intussusception / Q000628:therapy*; D007902:Length of Stay; D008297:Male; D010351:Patient Discharge; D011446:Prospective Studies; D012008:Recurrence; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D013997:Time Factors; D016896:Treatment Outcome
keywords: Enema; Intussusception in children; Recurrence