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Comparison of Hirschsprung-associated enterocolitis following Soave and Duhamel procedures

Isidora Galuh Parahita1, Akhmad Makhmudi1, Gunadi1

  • 1Pediatric Surgery Division, Department of Surgery, Faculty of Medicine, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta 55281, Indonesia.

Journal of Pediatric Surgery
|July 31, 2017
PubMed

Insights

The Soave procedure resulted in lower Hirschsprung-associated enterocolitis (HAEC) rates compared to the Duhamel procedure in Hirschsprung disease (HSCR) patients. Pre-operative enterocolitis increases the risk of HAEC post-surgery.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Clinical Outcomes

Background:

  • Hirschsprung-associated enterocolitis (HAEC) is a major cause of morbidity and mortality in Hirschsprung disease (HSCR).
  • The Soave and Duhamel procedures are common surgical interventions for HSCR.
  • Comparing HAEC frequency after these procedures is crucial for patient management.

Purpose of the Study:

  • To compare the incidence of HAEC following the Soave and Duhamel pull-through procedures for HSCR.
  • To identify risk factors associated with HAEC development post-surgery.

Main Methods:

  • Retrospective analysis of medical records from 100 HSCR patients who underwent Soave or Duhamel pull-through (2010-2015).
  • HAEC diagnosis was confirmed using a standardized HAEC scoring system.
  • Patient demographics, age at diagnosis and pull-through, and pre-operative enterocolitis were analyzed.

Main Results:

  • The Duhamel group had a significantly higher HAEC frequency (28%) compared to the Soave group (10%) post-operatively (p=0.03).
  • Pre-operative enterocolitis was significantly associated with post-operative HAEC (p=2.0×10-4).
  • Long-segment aganglionosis increased HAEC risk after the Soave procedure (p=0.015).

Conclusions:

  • The Soave procedure is associated with a lower frequency of HAEC compared to the Duhamel procedure.
  • Patients with pre-operative enterocolitis are at higher risk for developing HAEC after HSCR surgery.
Abstract

Keywords:
DuhamelHAEC following pull-throughHirschsprungPre-operative enterocolitisSoave

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