Idiopathic intussusception is an important abdominal emergency in infancy and childhood. The nonoperative management by air enema has always been the standard of care in Russia. Our purpose is to assess our reduction rate and the rate of complications. We performed a retrospective analysis of all intussusception cases seen at the Department of Paediatric Surgery from 1994 to 2005. The data obtained included age, sex, clinical presentation, diagnostic procedures, mode of treatment, and results. Patients included 280 children from 1 month to 14 years of age. Eighty-one percent of children were under age 1 year old, 61% were boys. The duration of symptoms before treatment was less than 18 h in 65%, 18-24 h in 21%, and more than 24 h in 14% of patients. The successful reduction rate was 86.1%. One patient with a duration of symptoms more than 24 h experienced colon perforation. Thirty-nine patients underwent surgery and, among these, abnormalities in the intestinal wall required resection in 12 cases. An association between the duration of symptoms and the outcome of the non-surgical treatment was present; non-surgical reduction was successful in 97.3% in the group with the duration of symptoms less than 18 h, 86.4% in 12-24 h, and 33.3% in more than 24 h. Air enema is a safe and effective approach for uncomplicated intussusception reduction with a high success rate, but the duration of symptoms directly increases the complication rate.

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Objective: The purpose of this study was to analyze the structure of morbidity and the results of treatment of children with EA in the Far Eastern Federal District.Methods: The retrospective analysis of the annual reports of pediatric surgeons of all 11 regions of the Far Eastern Federal District. Total 46 children with EA were born from 2019 to 2021, 1 child died because of severe comorbidity before surgery, 1 was operated in Moscow. 44 children having A, B, C, D types of EA by Gross were treated by regional surgeons.Results: 64% of children were boys and 36% - girls, half of the children were born prematurely, every fourth was fed before getting diagnosis. The most common form was EA with lower tracheoesophageal fistula (93%). Combined malformations were found in 60% of cases, the most frequent was cardiac anomaly. Anastomosis was applied in 86% of operated, the rest underwent staged procedures. 81% are alive after applying anastomosis, 33% after coloesophageal replacement. Thoracoscopic AP treatment is widely used in regions having much higher population density than the Far East, but there is a tendency to improve this indicator. As for our district, there are several ways to improve surgical care: concentration of patients of the same profile in one or two regional centers or involvement of leading Russian specialists in providing high-tech medical care.Conclusions: The peculiarities of the logistics of the region lead to the idea of creating a single Far Eastern multidisciplinary surgical center providing counseling, transportation, diagnostics and treatment of patients with congenital malformations at the modern level.