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Risk factors of enterostomy in neonates with Hirschsprung disease

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Abstract

Purpose

This study was aiming to explore the risk factors contributing to enterostomy in neonates with Hirschsprung disease (HD) to provide a reference for clinicians to make treatment decisions.

Methods

Medical records of 284 patients diagnosed with HD during the neonatal period were retrospectively analyzed. The patients were divided into 2 groups based on operative intervention (one stage transanal pull-through, versus enterotomy and staged transanal pull-through). Univariate and multivariable logistic regression analysis was performed to identify risk factors contributing to enterostomy.

Results

The incidence of enterostomy was 12.0% (34/284) in neonates with HD. Univariate and multivariate logistic regression analysis showed that serum albumin < 25.4 g/L, radiographic results as subphrenic free air, and level of aganglionosis with long-segment or total colonic aganglionosis (TCA) were independent risk factors of enterostomy in neonates, with OR of 42.045 (6.131, 288.319), 285.558 (26.651, 3059.694) and 15.573 (4.319, 56.157), respectively.

Conclusions

The low serum albumin level, bowel perforation, and level of aganglionosis with long-segment or TCA could influence the occurrence of enterostomy in neonates with HD.

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References

  1. Langer J (2013) Hirschsprung disease Current opinion in pediatrics 25(3):368–374. https://doi.org/10.1097/MOP.0b013e328360c2a0

    Article  PubMed  Google Scholar 

  2. Ambartsumyan L, Smith C, Kapur R (2020) Diagnosis of Hirschsprung Disease. Pediatr Dev Pathol 23(1):8–22. https://doi.org/10.1177/1093526619892351

    Article  PubMed  Google Scholar 

  3. de Lorijn F, Boeckxstaens G, Benninga M (2007) Symptomatology, pathophysiology, diagnostic work-up, and treatment of Hirschsprung disease in infancy and childhood. Curr Gastroenterol Rep 9(3):245–253. https://doi.org/10.1007/s11894-007-0026-z

    Article  PubMed  Google Scholar 

  4. Sulkowski J, Cooper J, Congeni A, Pearson E, Nwomeh B, Doolin E et al (2014) Single-stage versus multi-stage pull-through for Hirschsprung’s disease: practice trends and outcomes in infants. J Pediatr Surg 49(11):1619–1625. https://doi.org/10.1016/j.jpedsurg.2014.06.002

    Article  PubMed  PubMed Central  Google Scholar 

  5. Zani A, Eaton S, Morini F, Puri P, Rintala R, Van Heurn E et al (2017) European paediatric surgeons' association survey on the management of Hirschsprung disease. Eur J Pediatr Surg 27(1):96–101. https://doi.org/10.1055/s-0036-1593991

  6. Kyrklund K, Sloots CE, de Blaauw I, Bjornland K, Rolle U, Cavalieri D et al (2020) ERNICA guidelines for the management of rectosigmoid Hirschsprung’s disease. Orphanet J Rare Dis 15(1):164. https://doi.org/10.1186/s13023-020-01362-3

    Article  PubMed  PubMed Central  Google Scholar 

  7. Das K, Mohanty S (2017) Hirschsprung Disease - current diagnosis and management. Indian J Pediatr 84(8):618–623. https://doi.org/10.1007/s12098-017-2371-8

    Article  PubMed  Google Scholar 

  8. Bradnock T, Knight M, Kenny S, Nair M, Walker G (2017) The use of stomas in the early management of Hirschsprung disease: findings of a national, prospective cohort study. J Pediatr Surg 52(9):1451–1457. https://doi.org/10.1016/j.jpedsurg.2017.05.008

    Article  CAS  PubMed  Google Scholar 

  9. Bradnock T, Walker G (2011) Evolution in the management of Hirschsprung’s disease in the UK and Ireland: a national survey of practice revisited. Ann R Coll Surg Engl 93(1):34–38. https://doi.org/10.1308/003588410x12771863936846

    Article  CAS  PubMed  Google Scholar 

  10. Singh S, Croaker G, Manglick P, Wong C, Athanasakos H, Elliott E et al (2003) Hirschsprung’s disease: the Australian Paediatric Surveillance Unit’s experience. Pediatr Surg Int 19(4):247–250. https://doi.org/10.1007/s00383-002-0842-z

    Article  CAS  PubMed  Google Scholar 

  11. Ieiri S, Higashi M, Teshiba R, Saeki I, Esumi G, Akiyoshi J et al (2009) Clinical features of Hirschsprung’s disease associated with Down syndrome: a 30-year retrospective nationwide survey in Japan. J Pediatr Surg 44(12):2347–2351. https://doi.org/10.1016/j.jpedsurg.2009.07.055

    Article  PubMed  Google Scholar 

  12. Fuhrman MP, Charney P, Mueller CM (2004) Hepatic proteins and nutrition assessment. J Am Diet Assoc 104(8):1258–1264. https://doi.org/10.1016/j.jada.2004.05.213

    Article  CAS  PubMed  Google Scholar 

  13. Wessner S, Burjonrappa S (2014) Review of nutritional assessment and clinical outcomes in pediatric surgical patients: does preoperative nutritional assessment impact clinical outcomes? J Pediatr Surg 49(5):823–830. https://doi.org/10.1016/j.jpedsurg.2014.01.006

    Article  PubMed  Google Scholar 

  14. Keckler SJ, Yang JC, Fraser JD, Aguayo P, Ostlie DJ, Holcomb G et al (2009) Contemporary practice patterns in the surgical management of Hirschsprung's disease. J Pediatric Surg 44(6):1257–60; discussion 1260. https://doi.org/10.1016/j.jpedsurg.2009.02.050

  15. Suita S, Taguchi T, Ieiri S, Nakatsuji T (2005) Hirschsprung's disease in Japan: analysis of 3852 patients based on a nationwide survey in 30 years. J Pediatric Surg 40(1):197–201; discussion 201–2. https://doi.org/10.1016/j.jpedsurg.2004.09.052

  16. Pastor A, Osman F, Teitelbaum D, Caty M, Langer J (2009) Development of a standardized definition for Hirschsprung’s-associated enterocolitis: a Delphi analysis. J Pediatr Surg 44(1):251–256. https://doi.org/10.1016/j.jpedsurg.2008.10.052

    Article  PubMed  Google Scholar 

  17. Zhu T, Zhang G, Meng X, Yang J, Niu Y, He Y et al (2022) Enterocolitis is a risk factor for bowel perforation in neonates with Hirschsprung’s Disease: a retrospective multicenter study. Front Pediatr 10:807607. https://doi.org/10.3389/fped.2022.807607

    Article  PubMed  PubMed Central  Google Scholar 

  18. Langer J, Rollins M, Levitt M, Gosain A, Torre L, Kapur R et al (2017) Guidelines for the management of postoperative obstructive symptoms in children with Hirschsprung disease. Pediatr Surg Int 33(5):523–526. https://doi.org/10.1007/s00383-017-4066-7

    Article  CAS  PubMed  Google Scholar 

  19. Hukkinen M, Koivusalo A, Rintala R, Pakarinen M (2014) Restorative proctocolectomy with J-pouch ileoanal anastomosis for total colonic aganglionosis among neonates and infants. J Pediatr Surg 49(4):570–574. https://doi.org/10.1016/j.jpedsurg.2013.07.021

    Article  PubMed  Google Scholar 

  20. Gosain A, Frykman P, Cowles R, Horton J, Levitt M, Rothstein D et al (2017) Guidelines for the diagnosis and management of Hirschsprung-associated enterocolitis. Pediatr Surg Int 33(5):517–521. https://doi.org/10.1007/s00383-017-4065-8

    Article  PubMed  PubMed Central  Google Scholar 

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Author information

Author notes

  1. Zhaozhou Liu and Yanan Zhang contributed equally to this work.

Authors and Affiliations

  1. Department of Neonatal Surgery, National Center for Children’s Health, Beijing Children’s Hospital, Capital Medical University, 56 South Lishi Road, Xicheng District, Beijing, 100045, China

    Zhaozhou Liu, Yanan Zhang, Shuangshuang Li, Shen Yang, Jiawei Zhao, Ting Yang, Siqi Li, Yongwei Chen, Weihong Guo, Dawei Hou, Jingbin Du, Yingzi Li & Jinshi Huang

Authors
  1. Zhaozhou Liu
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  2. Yanan Zhang
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  3. Shuangshuang Li
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  4. Shen Yang
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  5. Jiawei Zhao
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  6. Ting Yang
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  7. Siqi Li
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  9. Weihong Guo
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  11. Jingbin Du
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  12. Yingzi Li
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  13. Jinshi Huang
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Contributions

Jinshi Huang, Yanan Zhang, and Zhaozhou Liu designed the study. Zhaozhou Liu and Yanan Zhang wrote the main manuscript text. Yongwei Chen, Weihong Guo, Dawei Hou, and Yingzi Li prepared Tables 1 and 2. All authors reviewed the manuscript.

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Correspondence to Jinshi Huang.

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Liu, Z., Zhang, Y., Li, S. et al. Risk factors of enterostomy in neonates with Hirschsprung disease. Int J Colorectal Dis 37, 1127–1132 (2022). https://doi.org/10.1007/s00384-022-04151-5

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  • DOI: https://doi.org/10.1007/s00384-022-04151-5

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