Abstract
Purpose
To explore the influence of postoperative Hirschsprung-associated enterocolitis (post-HAEC) on long-term outcomes and to identify risk factors of post-HAEC.
Methods
The medical records of 304 eligible patients diagnosed with Hirschsprung’s disease (HSCR) were reviewed. We analyzed the clinical characteristics of post-HAEC and its influence on long-term outcomes. Furthermore, risk factors for early and recurrent HAEC were identified separately.
Results
The overall incidence of post-HAEC was 29.9% (91/304). We categorized early HAEC as occurring within postoperative 3 months (n = 39) and recurrent HAEC as occurring ≥ 3 episodes within postoperative 6 months (n = 25). Patients with early HAEC were more likely to experience worse nutritional status, defecation function, and quality of life compared to those with late or no episodes (P < 0.05). Similarly, the adverse influences of recurrent HAEC on these outcomes were also significant (P < 0.05). The risk factors for early HAEC included preoperative undernutrition, long-segment HSCR, and postoperative Grade 3–4 complications within 30 days. For recurrent HAEC, risk factors were preoperative malnutrition, non-parental caregivers, long-segment HSCR, and postoperative Grade 3–4 complications within 30 days.
Conclusion
Classification of post-HAEC based on the first episode time and frequency was necessary. The earlier or more frequent episodes of post-HAEC have detrimental influences on long-term outcomes. Furthermore, risk factors for early and recurrent HAEC were different.
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Data availability
The data presented in this study are available on request from the corresponding author.
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Funding
This study was supported by research grants from the National Clinical Research Center for Child Health and Disorders, Children’s Hospital of Chongqing Medical University (No.NCRCCHD-2022-GP-03) and Program for Youth Innovation in Future Medicine, Chongqing Medical University (No.W0125).
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All the authors contributed to the study’s conception and design. Data collection and analysis were performed by Wei Feng and Yi Wang. The first draft of the manuscript was written by Wei Feng and Linxiao Fan, and all the authors commented on previous versions of the manuscript. All the authors approved the final manuscript as submitted.
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The study was approved by the Institutional Research Ethics Board of Children’s Hospital affiliated Chongqing Medical University (Date: 2021/No: 391).
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Feng, W., Zhang, B., Fan, L. et al. Clinical characteristics and influence of postoperative Hirschsprung-associated enterocolitis: retrospective study at a tertiary children’s hospital. Pediatr Surg Int 40, 106 (2024). https://doi.org/10.1007/s00383-024-05688-y
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DOI: https://doi.org/10.1007/s00383-024-05688-y