Clinical outcomes and risk factors for postoperative complications in children with Hirschsprung's disease

To explore and analyze the risk factors for postoperative complications in patients with Hirschsprung's disease (HD).

Patients with HD admitted to the hospital from 2015 to 2020 were reviewed in this retrospective study. Follow-up data collected included constipation, fecal incontinence, anastomotic fistula, Hirschsprung's-associated enterocolitis (HAEC), and readmission. The putative risk factors for postoperative complications in patients with HD were as follows: clinical classification, gender, operative age, hemoglobin and serum albumin levels and preoperative HAEC. A follow-up survey was conducted for all patients by telephone. Data were analyzed statistically using SPSS version 23.0.

A total of 154 patients were included in the study, of whom 119 patients were followed up successfully. 53 patients who had complications postoperatively were compared to 66 patients who had no related complications. Among patients with complications: 8 had constipation, 22 had fecal incontinence and 33 had HAEC. The gender, operative age, hemoglobin levels and preoperative HAEC did not differ significantly between the two groups. However, significant differences were observed between the 2 groups in clinical classification, surgical method, serum albumin level, and whether or not a one-stage operation was performed (P<0.05).

Clinical classification, surgical method, preoperative albumin level and whether or not a one-stage operation was performed emerged as risk factors affecting the postoperative complications of patients with HD. Therefore, the prognosis in HD can be improved by strengthening the preoperative nutritional support and selecting appropriate surgical methods according to the clinical subtype.