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Enterostomy-related complications in Hirschsprung's disease in a single cohort
Michela C Wong1,2, Stefano Avanzini3, Manuela Mosconi3
1Department of Pediatric Surgery, IRCCS Istituto Giannina Gaslini, Genoa, Italy - michela.wong1987@gmail.com.
Insights
Hirschsprung's disease (HSCR) complications are common, especially with longer stoma duration and ileostomies. Long and ultra-long HSCR forms increase stoma duration and major complication risks.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Clinical Research
Background:
- Hirschsprung's disease (HSCR) is a primary cause of pediatric intestinal obstruction.
- Enterostomy is a common surgical intervention for HSCR, leading to potential complications.
Purpose of the Study:
- To detail enterostomy-related complications in Hirschsprung's disease patients.
- To identify risk factors associated with stoma complications in HSCR.
Main Methods:
- Retrospective analysis of 301 HSCR patients from January 1993 to December 2016.
- Data collected on HSCR type, enterostomy site, duration, and complications.
Main Results:
- 137 patients required a stoma; 64 stoma-related complications were observed (36 major, 28 minor).
- Major complications were more frequent in long HSCR forms (P=0.037).
- Ileostomies and longer stoma duration correlated with higher complication rates.
Conclusions:
- Long and ultra-long HSCR forms are linked to prolonged stoma duration.
- These forms significantly increase the risk of major stoma-related complications.
Background:
Hirschsprung's disease (HSCR) is a frequent cause of intestinal obstruction in children and may require an enterostomy. The study aimed to describe the most common enterostomy-related complications in a series of patients treated in a single center.
Methods:
A series of consecutive HSCR patients treated or followed-up at our institution between January 1993 and December 2016 were included. Data about HSCR type, enterostomy site, duration and complications of the stoma were recorded.
Results:
Three hundred one patients with HSCR were followed-up. Sixty-one had ultralong forms (TCSA/TIA), 21 had long forms (L-HSCR) and 219 had classic short forms (S-HSCR). One hundred thirty-seven patients required a stoma (100% of patients with TCSA/TIA, 66.7% with L-HSCR and 28.3% with S-HSCR). We observed 64 stoma-related complications: 36 major complications and 28 minor complications. Major complications occurred more often in long forms (P=0.037). The presence of an ileostomy was statistically associated with an increased rate of complications compared to colostomy. The longer the stoma was in site, the higher the complication rate was.
Conclusions:
Long and ultra-long forms are associated with a longer duration of the stoma and to a major risk of stoma-related complications.
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