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Predictive factors for the development of postoperative Hirschsprung-associated enterocolitis in children operated
Tsuyoshi Sakurai1, Hiromu Tanaka1, Naobumi Endo2
1Department of Pediatric Surgery, Miyagi Children's Hospital, Sendai, 989-3126, Japan.
Insights
Long-segment Hirschsprung disease (HD) and older age at surgery are key risk factors for developing postoperative Hirschsprung-associated enterocolitis (HAEC) in infants. These findings aid in understanding and potentially preventing HAEC post-surgery.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Clinical Research
Background:
- Hirschsprung-associated enterocolitis (HAEC) is a serious complication following surgery for Hirschsprung disease (HD).
- Risk factors for postoperative HAEC, particularly the timing of surgical intervention, require further elucidation.
Purpose of the Study:
- To identify specific risk factors for the development of postoperative HAEC in infants undergoing surgery for HD.
- To investigate the influence of age at radical surgery on the incidence of HAEC.
Main Methods:
- Retrospective review of medical records for 35 infants who underwent radical surgery for HD during infancy.
- Patients were categorized into two groups: those who developed postoperative HAEC (n=14) and those who did not (n=21).
Main Results:
- Long-segment HD and older age at the time of radical surgery were significantly associated with the development of postoperative HAEC (p<0.05).
- Trisomy 21 was associated with longer hospitalizations in patients who developed HAEC.
- Patients with long-segment HD experienced higher hospitalization rates compared to those with short-segment HD.
Conclusions:
- Long-segment HD and older age at radical surgery are identified as significant risk factors for postoperative HAEC.
- These findings underscore the importance of surgical timing and disease extent in managing HD and preventing complications.
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.
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