STROBE-anastomotic leakage after pull-through procedure for Hirschsprung disease

Area of Science:

• Pediatric Surgery
• Gastroenterology

Background:

• Hirschsprung disease (HD) is a congenital condition requiring surgical intervention.
• The pull-through (PT) procedure is a common surgical approach for HD.
• Anastomotic leakage is a potential complication following PT procedures.

Purpose of the Study:

• To investigate the causes, diagnosis, and treatment of anastomotic leakage after PT for HD.
• To identify risk factors and clinical characteristics associated with anastomotic leakage.

Main Methods:

• Retrospective analysis of patients undergoing PT for HD at Beijing Children's Hospital (July 2013 - June 2016).
• Evaluation of surgical characteristics, diagnostic methods, and treatment strategies for anastomotic leakage.
• Analysis included 5 patients with anastomotic leakage out of 213 PT procedures.

Main Results:

• Anastomotic leakage occurred in 5 patients (2.3%).
• Patients with leakage were older (median 6.8 years) than those without (median 1.7 years).
• Distinctive findings included anastomotic dehiscence on rectal exam and retrorectal pneumatosis/abscess on ultrasound. Treatment involved ileostomy and resuturing, with 80% cure rate.

Conclusions:

• Older children with HD may be at higher risk for anastomotic leakage post-PT.
• Rectal examination and abdominal ultrasonography are valuable diagnostic tools.
• Prompt ileostomy and anastomotic resuturing are effective treatments for anastomotic leakage.