Clinical outcome and bowel function after surgical treatment in Hirschsprung′s disease

Khazdouz, Maryam; Sezavar, Majid; Imani, Behzad; Akhavan, Hossein; Babapour, Alireza; Khademi, Gholamreza

doi:10.4103/0189-6725.160403

Cited by 21 publications

(13 citation statements)

References 24 publications

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“…Enterocolitis and constipation were the most common postoperative complication as also referred by other authors 7 , 10 . The rate of enterocolitis in this study was higher than the one reported by Parahita et al 13 and Huang et al also mentioned enterocolitis as the earliest postoperative complication (28.73%) being fecal incontinency (20.99%) also frequent 5 .…”

Section: Discussionsupporting

confidence: 67%

Complications After Transabdominal Soave’s Procedure in Children With Hirschsprung’s Disease

Askarpour¹,

Peyvasteh²,

Imanipour³

et al. 2019

ABCD, arq. bras. cir. dig.

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Background:Hirschsprung’s disease is a congenital disorder that causes functional obstruction of large bowel. Aim: To evaluate complication and bowel function score of children with Hirschsprung’s disease who underwent transabdominal Soave’s procedure. Methods: In this study all the children with Hirschsprung’s disease who underwent transabdominal Soave procedure were evaluated regarding bowel function and complication of trans-abdominal Soave’s procedure. Results: Were enrolled 160 children. Enterocolitis and constipation were seen in 15% of the cases. Fecal incontinency was the least frequent study which was seen in 1% of the children. Conclusion: Constipation and enterocolitis was the most frequent complication following transabdominal Soave technique.

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Section: Discussionsupporting

confidence: 67%

Complications After Transabdominal Soave’s Procedure in Children With Hirschsprung’s Disease

Askarpour¹,

Peyvasteh²,

Imanipour³

et al. 2019

ABCD, arq. bras. cir. dig.

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“…Specifically, HD children reported limitations in physical activities, social interactions and food intake, as well as decreased school attendance, due to their bowel symptoms ( 5 , 17 ). Examining type of surgical procedure revealed no significant association between surgery type and bowel function outcome; however, there appears to be varying reports that either support this finding ( 16 , 19 , 20 ) or refute it ( 21 ). It should be noted that the latter study compared modified procedures (e.g., transanal endorectal pull-through and the Soave procedures) and found incontinence and bowel movement frequency to be significantly lower in patients who had undergone the transanal endorectal pull-through procedure.…”

Section: Discussionmentioning

confidence: 84%

Long-term Outcomes of Patients Surgically Treated for Hirschsprung Disease

Nasr

Grandpierre

Sullivan

et al. 2020

Journal of the Canadian Association of Gastroenterology

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Background The only curative treatment for Hirschsprung disease (HD) is surgical repair. However, some patients experience poor postoperative outcomes. We determined long-term outcomes of all HD patients in Ontario, Canada’s most populous province. Methods We conducted a retrospective cohort study including all children with HD born between April 1, 1991 and March 31, 2014 in Ontario using linked health administrative data. Each HD case was matched to five non-HD controls on sex, date of birth, region of residence and income and followed to March 31, 2016. Chronic diarrhea and constipation were identified using combinations of outpatient physician billing codes in both HD patients and non-HD residents of the province. We determined risk factors associated with diarrhea and constipation, including surgery type and sociodemographic characteristics, using multivariable conditional logistic regression, and reported adjusted odds ratios (aORs). Results There were 3,265,172 children born in the study period, of whom 673 had HD. Compared to controls, chronic constipation was more common in HD patients (27.5% versus 2.1%; aOR 17.2, 95% CI 12.6 to 23.4), as was chronic diarrhea (29.9% versus 6.9%, aOR 5.22, 95% CI 4.19 to 6.50). In HD patients, older age at surgery was associated with increased risk of chronic constipation (OR 2.71, 95% CI 1.75 to 4.20). Surgery type, sex, rural/urban residence and income were not associated with risk of chronic constipation or diarrhea. Conclusion Chronic constipation and diarrhea were common following surgery for HD. Older age at surgery was associated with subsequent risk of chronic constipation. Surgery type was not associated with increased risk of chronic constipation or diarrhea.

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“…However, they often resulted in anastomotic failure and various septic states that, in turn, caused lethality. The use of the protective colonic stoma as the first stage of surgical correction of total colonic aganglionosis has become an alternative in treatment of such patients [9,16]. This approach contributed to better survival, reduced the incidence of ileoanal anastomotic failure and improved functional outcomes.…”

Section: Problem Statement and Analysis Of The Recent Researchmentioning

confidence: 99%

Colonic Stoma Creation as the First Stage of Surgical Correction of Total Colonic Aganglionosis in Children

Kurtash

2020

Arch. clin. med.

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Abstract. The use of a staged approach in surgical treatment of total colonic aganglionosis is controversial. The creation of a protective colonic stoma as the first stage of surgical correction of total colonic aganglionosis rather than one-stage correction has become an alternative in treatment of such patients. This approach contributes to better survival, reduces the incidence of ileoanal anastomotic failure and improves functional outcomes. The objective of the research was to study and evaluate the need for colonic stoma creation as the first stage of surgical correction of total colonic aganglionosis in children. Materials and Methods. The analysis of surgical treatment of 41 children with total colonic aganglionosis over the period 1980-2020 was conducted. Protective colonic stoma was created in all the patients, namely 36 children with isolated colonic aganglionosis and 5 children with the involvement of the entire colon and a segment of the small bowel. Results. Twenty-four (58.54%) patients were diagnosed and underwent the first stage of treatment in National Specialized Children’s Hospital “Okhmatdyt”. There were 17 (41.46%) patients who were transferred from other clinics after being diagnosed with a pathology and undergoing colonic stoma creation. During staged treatment of children with total colonic aganglionosis, a single-barrel ileostomy (n=10, 24.40%), a double-barrel ileostomy (n=5, 12.19%), or a loop colonic ileostomy (n=26, 63.41%) were created. The periods between creating the protective colonic stoma and performing radical surgery ranged from 4 to 14 months. The colonic stomas were closed 2-4 months after radical surgery. The third stage of surgical correction of total colonic aganglionosis in children was carried out after the state of the neorectum formed and ileoanal anastomosis were assessed for readiness of inclusion in the passage. There were no complications after protective stoma closure. Within the first 3 months, the frequency of bowel movement ranged from 10 to 15 times a day, and, in a year, it was 2-4 times a day. All the children survived. Functional outcomes of treatment were found to be good. Bowel function was satisfactory. The X-ray images demonstrated the rectal reservoir of sufficient size with pronounced colonization. Conclusions. Surgical correction of total colonic aganglionosis in children involves the three-stage approach consisting in the creation of the protective small bowel stoma (the first stage), radical surgery, namely colectomy with reconstructive plastic formation of functionally advantageous reservoir version of the neorectum (the second stage) and ileostomy closure after adaptation of the small bowel reservoir (the third stage). The creation of the protective small bowel stoma as the first stage of surgical correction of total colonic aganglionosis in children is emergency surgery. The creation of the loop small bowel stoma at 12 cm above aganglionosis level is the most rational type of the first stage of correcting total colonic aganglionosis in children.

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Clinical outcome and bowel function after surgical treatment in Hirschsprung′s disease

Cited by 21 publications

References 24 publications

Complications After Transabdominal Soave’s Procedure in Children With Hirschsprung’s Disease

Complications After Transabdominal Soave’s Procedure in Children With Hirschsprung’s Disease

Long-term Outcomes of Patients Surgically Treated for Hirschsprung Disease

Colonic Stoma Creation as the First Stage of Surgical Correction of Total Colonic Aganglionosis in Children

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