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Prevalence, Risk Factors, and Prognosis of Postoperative Complications after Surgery for Hirschsprung Disease

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Background

Although most of patients do well after surgery for Hirschsprung disease (HSCR), there are complications in some instances that impact social aspects and quality of life. The aim of this study was to explore the prevalence, risk factors, and prognosis of these complications, providing guidance for surgeons and healthcare personnel.

Methods

A cohort of patients (N = 229) was retrospectively reviewed in the aftermath of surgery for HSCR. All medical data and operative notes were assessed. Early and late postoperative complications were solicited by questionnaire, using logistic regression and the Cox proportional hazards regression model for analysis.

Results

A total of 181 patients qualified for the study. Enterocolitis and soiling/incontinence constituted the most frequent complications, whether early or late in the postoperative period. Risk factors for developing enterocolitis included low weight, low-level IgA, preoperative enterocolitis, and lengthy aganglionic segment in the early term; whereas preoperative enterocolitis and diet control impacted complications emerging later. Risk factors in early soiling/incontinence were low weight, operative age of < 2 months, low IgA level, and lengthy aganglionic segment. Lengthy aganglionic segment, operative age of < 2 months, and toilet training were factors long-term. Prognostic factors included diet control and toilet training.

Conclusion

Enterocolitis and soiling/incontinence remain the most frequent complications after surgery for HSCR. Risk factors in early and late postoperative periods differed, with diet control and toilet training contributing favorably to enterocolitis and soiling/incontinence, respectively.

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Acknowledgements

We would like to thank the native English-speaking experts from the BioMed Proofreading® LLC for editing this article.

Grant Support

This study was supported by the National Natural Science Foundation of China (No.81570465, 30,700,917).

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Authors and Affiliations

  1. Department of Pediatric Surgery, Major Laboratory of Chinese Health Ministry for Congenital Malformations, The Shengjing Hospital, China Medical University, 36 Sanhao Street Heping District, 110004, Shenyang, People’s Republic of China

    Wen-Kai Huang, Xue-Li Li, Jin Zhang & Shu-Cheng Zhang

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  1. Wen-Kai Huang
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  2. Xue-Li Li
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  3. Jin Zhang
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Contributions

Shu-cheng Zhang credited the study concept, participated in its design, and coordinated/assisted in drafting of the manuscript. Wen-Kai Huang contributed to the manuscript draft. Xue-Li Li participated in the study design and contributed to the data analysis. Jin Zhang contributed to history collection and follow-up. All authors have read and approved the final copy.

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Correspondence to Shu-Cheng Zhang.

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The authors declare that they have no conflict of interest.

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Huang, WK., Li, XL., Zhang, J. et al. Prevalence, Risk Factors, and Prognosis of Postoperative Complications after Surgery for Hirschsprung Disease. J Gastrointest Surg 22, 335–343 (2018). https://doi.org/10.1007/s11605-017-3596-6

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  • DOI: https://doi.org/10.1007/s11605-017-3596-6

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