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Histological transitional zone pull-through in Hirschsprung disease. Postoperative functional results and current
Luis De-la Torre1, Alfredo Domínguez2, Michael Arnold3
1Department of Surgery, International Center for Colorectal and Urogenital Care, Division of Pediatric Surgery, University of Colorado School of Medicine, University of Colorado, Colorado, USA.
Boletin Medico Del Hospital Infantil De Mexico
|December 27, 2023
Summary
This study found no significant difference in postoperative enterocolitis or constipation for Hirschsprung
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Colorectal Surgery
Background:
- Hirschsprung's disease (HD) repair involves creating a neorectum from normoganglionic bowel.
- Occasionally, neorectums are constructed with transition zone (TZ) bowel, potentially leading to complications.
- Postoperative enterocolitis and constipation are concerns associated with TZ neorectums.
Purpose of the Study:
- To compare the incidence of enterocolitis and constipation in patients with normoganglionic neorectum (NNR) versus TZ neorectum.
- To investigate the impact of neorectum composition on postoperative outcomes in Hirschsprung's disease.
- To determine if TZ neorectum is a risk factor for obstructive symptoms post-surgery.
Main Methods:
- Retrospective review of rectosigmoid HD patients undergoing primary pull-through surgery.
- Classification of patients into NNR and TZ neorectum groups based on histopathology.
- Comparison of enterocolitis and constipation rates between the two neorectum groups.
Main Results:
- Analysis included 71 HD patients; 65 (92%) had NNR and 6 (8%) had TZ neorectum.
- Overall, 42 (59%) patients experienced enterocolitis or constipation.
- No statistically significant difference in complication rates was observed between NNR and TZ neorectum groups.
Conclusions:
- The study indicates no difference in enterocolitis or constipation incidence based on neorectum composition.
- Findings suggest that TZ neorectum may not be a direct cause of postoperative obstructive symptoms in HD patients.
- Further research may explore other factors contributing to postoperative complications in HD.
