RESUMO
BACKGROUND: Variability in management of intussusception after enema reduction exists. Historically, inpatient observation was recommended; however, there is a lack of evidence-based guidelines for this practice. METHODS: A systematic review and meta-analysis evaluating outcomes between inpatient (IP) and outpatient (OP) management after enema reduction was performed. The following databases were searched: PubMed, EBSCOhost CINAHL, EMBASE, Web of Science, and Cochrane Database. Data from an institutional review were included in the meta-analysis. RESULTS: Ten studies of patients aged 0-18â¯years with intussusception who underwent successful enema reduction that reported outcomes of outpatient management were included. Overall recurrence rates were 6% for IP and 8% for OP (pâ¯=â¯0.20). Recurrences within 24 (IP: 1% vs OP: 0%, pâ¯=â¯0.90) and 48â¯h (IP: 1% vs OP: 2%, pâ¯=â¯0.11) were similar. There was no significant difference in the rate of return to the emergency department (IP: 6% vs OP: 14%, pâ¯=â¯0.11). Both groups had a similar rate of requiring an operation (IP: 2% vs OP: 1%, pâ¯=â¯0.84). CONCLUSIONS: Outpatient management of intussusception after enema reduction results in a shorter hospital stay with no difference in the rate of return to the emergency department, recurrence, need for operation, or mortality. The findings of the meta-analysis suggest that outpatient management may be safe and could reduce hospital resource utilization. TYPE OF STUDY: Treatment study. LEVEL OF EVIDENCE: III.