Comparison between contrast reduction versus open-surgery for the treatment of intussusception among children at French Medical Institute for Children, Afghanistan

Date of Award

1-2016

Document Type

Thesis

Degree Name

Diploma in Paediatric Surgery

First Supervisor/Advisor

Homayoon Atiq Ghairatmal

Second Supervisor/Advisor

Mohammad Tareq Rahimi

Department

French Medical Institute for Children

Abstract

Introduction: Intussusception is a surgical emergency and is one of the most common causes of intestinal obstruction in the pediatric age group, with the overwhelming majority of cases occurring in children between 3 months to 3 years of age with peak incidence of 3-12 Months. Contrast reduction is the primary, safest and successful means of treating intussusception and preferred due to less morbidity and mortality, shorter recovery period, less cost of procedure, less length of hospital stay, less complications and recurrence, higher degree of family satisfaction compared to open surgery. The objective of the study is to compare the effectiveness of Contrast reduction versus open surgery in the treatment of Intussusception among children in a tertiary care hospital (FMIC) French Medical Institute for Children.
Methodology: A retrospective cohort study design was employed to achieve the study objectives. Records of all pediatric patients treated for intussusception between January-2010 till December-2014 at the French Medical Institute for Children in Afghanistan were reviewed using a structured checklist. Information Variables such as Age group, Gender, hospital length of stay, Comorbidities (Associated diagnosis), Post-operative Complications, and patient’s family satisfaction was collected. Statistical Package for Social Sciences (SPSS) version 19.0 was used to run the data analysis. Chi-square test of independence was run to determine the association between predictor variables and treatment groups.
Results: Our study findings revealed that there is difference in the effectiveness of Contrast reduction versus open surgery for the treatment of Intussusception with regard to hospital length of stay, associated diagnosis, development of complications and family satisfaction. The length of stay for study subjects who had undergone Contrast reduction was relatively low and turn out to be significant (p-value: Conclusion: Intussusception is a very common disease among children with very good prognoses if treated timely with effective treatment method. Contrast Reduction technique is rarely used in Afghanistan and most affected children are being exposed unnecessary surgery. Our study has found that Contrast reduction technique is a safe and effective treatment modality and it should be widely implemented for the treatment of Intussusception for better prognoses and survival

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