Predictive factors for the development of postoperative Hirschsprung-associated enterocolitis in children operated durin
- PDF / 751,153 Bytes
- 6 Pages / 595.276 x 790.866 pts Page_size
- 67 Downloads / 150 Views
ORIGINAL ARTICLE
Predictive factors for the development of postoperative Hirschsprung‑associated enterocolitis in children operated during infancy Tsuyoshi Sakurai1 · Hiromu Tanaka1 · Naobumi Endo1 Accepted: 6 November 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose The risk factors for postoperative Hirschsprung-associated enterocolitis (HAEC) are still incompletely understood, especially age at which surgery is performed. Therefore, the aim of this study was to identify the risk factors for the development of postoperative HAEC in children operated during infancy. Methods Thirty-five children who had undergone radical surgery for Hirschsprung disease (HD) during infancy were included in the study. They were divided into two groups; those who developed postoperative HAEC (HAEC, 14 patients) and those who did not (no HAEC, 21 patients). Their medical records were retrospectively reviewed for clinical details. Results Developing postoperative HAEC was significantly associated with long-segment HD (p = 0.020) and the age at radical surgery (p = 0.0241). No other factors had a significant association with postoperative HAEC. In the patients who developed postoperative HAEC (n = 14), those with Trisomy 21 had significantly longer hospitalizations than those without. Patients with long-segment HD had a higher hospitalization rate than those with short-segment HD. Conclusion This study clearly showed that long-segment HD and older age at radical surgery are risk factors for developing postoperative HAEC. Keywords Hirschsprung disease · Hirschsprung-associated enterocolitis · Risk factors · Postoperative complications · Long-segment Hirschsprung disease
Introduction The complications of Hirschsprung disease (HD) include enterocolitis, chronic obstruction, incontinence, and constipation. Hirschsprung-associated enterocolitis (HAEC) is a particularly serious complication and causes half of the deaths associated with HD [1]. Even after appropriate surgery, HAEC is present in 25–37% of these patients [2]. Authors have suggested various risk factors for the development of postoperative HAEC, including long-segment disease, delayed diagnosis, associated Trisomy 21, preoperative HAEC, and obstruction [3–9]. However, these reports have partially conflicting results. Additionally, some studies have focused on Trisomy 21, with each study including patients * Naobumi Endo [email protected] 1
Department of Pediatric Surgery, Miyagi Children’s Hospital, Sendai 989‑3126, Japan
with and without significant risk factors for HAEC [10, 11]. Similarly, two randomized controlled trials show conflicting conclusions on the preventive effects of postoperative probiotics on HAEC [12, 13]. Various techniques, perioperative management methods, and social backgrounds, including body weight, age, and others, for HD may influence the results. Therefore, the results of these studies are somewhat controversial and incompletely understood. For this reason, this study aimed to identify the risk facto
Data Loading...
