Intussusception survey about practices among Turkish pediatric surgeons

Objectives: The aim of this study was to provide an overview of the pediatric surgery practices in the management of intussusception among different centers in Türkiye. Materials and methods: Between June 2023 and August 2023, a survey was sent to the pediatric surgeons working in different provinces of Türkiye as the members of the Turkish Association of Pediatric Surgeons by e-mail and text messages, inviting them to complete questions about intussusception practices. Of a total of 1,029 pediatric surgeons, there were 200 respondents (120 males, 80 females; mean age 42.8±11.1 years; range, 24 to 72 years). Items survey included demographics, preferred radiological reduction techniques, contraindications, use of monitorization/sedation/ other medications, maximum pressure/height, number and time interval between reattempts, length of hospitalization, surgical preference in case of failed reduction and additional appendectomy during procedure. Multiple answers were possible for some of the questions. Results: A total of 200 surgeons (19.4%) completed the survey. Totally, 80.5% (n=161) of pediatric surgeons were working in centers that manage ≤5 cases of intussusception per month. While radiological reduction method was chosen as the first treatment method for intussusception by 87.5% (n=175) of respondents, 10.5% (n=21) still preferred laparotomy as the first option. Ultrasound-guided hydrostatic reduction was preferred by 74.5% (n=143) of the respondents. While sedation was used by 32.5% (n=62) respondents, steroids were administered by 13.5% (n=26). A total of 33% (n=63) of the respondents did not attempt another reduction. After a failed reduction, 39.3% (n=75) of the respondents preferred a laparoscopic approach, while 58.6% (n=112) chose laparotomy as their first option. Totally, 76.6% (n=151) of pediatric surgeons did not perform an additional appendectomy procedure during the operation. Conclusion: Our study results indicate that various aspects remain controversial among institutions for the management of intussusception among Turkish pediatric surgeons. We believe that a better understanding of the current techniques and individual differences would facilitate to develop an evidence-based guideline to standardize care and improve clinical outcomes of intussusception.