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Pediatric Surgery International

Erschienen in:

01.12.2024 | Original Article

Clinical characteristics and influence of postoperative Hirschsprung-associated enterocolitis: retrospective study at a tertiary children’s hospital

verfasst von: Wei Feng, Bobin Zhang, Linxiao Fan, Aohua Song, Jinping Hou, Xiaohong Die, Wei Liu, Yi Wang, Zhenhua Guo

Erschienen in: Pediatric Surgery International | Ausgabe 1/2024

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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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Montalva L, Cheng LS, Kapur R et al (2023) Hirschsprung disease. Nat Rev Dis Primers 9(1):54. https://doi.org/10.1038/s41572-023-00465-yCrossRefPubMed

Beltman L, Labib H, Ahmed H et al (2023) Transition zone pull-through in patients with hirschsprung disease: is redo surgery beneficial for the long-term outcomes? J Pediatr Surg 58(10):1903–1909. https://doi.org/10.1016/j.jpedsurg.2023.02.043CrossRefPubMed

More K, Rao S, McMichael J et al (2014) Growth and developmental outcomes of infants with hirschsprung disease presenting in the neonatal period: a retrospective study. J Pediatr 165(1):73-77.e2. https://doi.org/10.1016/j.jpeds.2014.02.062CrossRefPubMed

Roorda D, Oosterlaan J, van Heurn E et al (2021) Risk factors for enterocolitis in patients with Hirschsprung disease: a retrospective observational study. J Pediatr Surg 56(10):1791–1798. https://doi.org/10.1016/j.jpedsurg.2021.04.020CrossRefPubMed

Yan J, Sun J, Wu R et al (2020) Barium enema findings in total colonic aganglionosis: a single-center, retrospective study. BMC Pediatr 20(1):499. https://doi.org/10.1186/s12887-020-02403-3CrossRefPubMedPubMedCentral

Kyrklund K, Sloots C, de Blaauw I 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/s13023-020-01362-3CrossRefPubMedPubMedCentral

Wood RJ, Garrison AP (2022) Total colonic aganglionosis in hirschsprung disease. Semin Pediatr Surg 31(2):151165. https://doi.org/10.1016/j.sempedsurg.2022.151165CrossRefPubMed

Li S, Zhang Y, Li K et al (2023) Update on the pathogenesis of the Hirschsprung-associated enterocolitis. Int J Mol Sci 24(5):4602. https://doi.org/10.3390/ijms24054602CrossRefPubMedPubMedCentral

Chantakhow S, Tepmalai K, Singhavejsakul J et al (2023) Prognostic factors of postoperative Hirschsprung-associated enterocolitis: a cohort study. Pediatr Surg Int 39(1):77. https://doi.org/10.1007/s00383-023-05364-7CrossRefPubMed

10.

Liu J, Dong R, Chen G et al (2019) Risk factors and prognostic effects of cholangitis after kasai procedure in biliary atresia patients: a retrospective clinical study. J Pediatr Surg 54(12):2559–2564. https://doi.org/10.1016/j.jpedsurg.2019.08.026CrossRefPubMed

11.

Li Z, Bai B, Ji G et al (2018) Relationship between Clavien-Dindo classification and long-term survival outcomes after curative resection for gastric cancer: a propensity score-matched analysis. Int J Surg 60:67–73. https://doi.org/10.1016/j.ijsu.2018.10.044CrossRefPubMed

12.

Chung P, Yu M, Wong K et al (2019) Risk factors for the development of post-operative enterocolitis in short segment Hirschsprung’s disease. Pediatr Surg Int 35(2):187–191. https://doi.org/10.1007/s00383-018-4393-3CrossRefPubMed

13.

Huang SC, Chen JS, Cheng CN et al (2012) Hypoalbuminaemia is an independent predictor for hemophagocytic lymphohistiocytosis in childhood Epstein-Barr virus-associated infectious mononucleosis. Eur J Haematol 89(5):417–422. https://doi.org/10.1111/ejh.12006CrossRefPubMed

14.

McLean TW, Stewart RM, Curley TP et al (2020) Hypoalbuminemia in children with cancer treated with chemotherapy. Pediatr Blood Cancer 67(2):e28065. https://doi.org/10.1002/pbc.28065CrossRefPubMed

15.

Mertens A, Benjamin-Chung J, Colford JM Jr et al (2023) Child wasting and concurrent stunting in low- and middle-income countries. Nature 621(7979):558–567. https://doi.org/10.1038/s41586-023-06480-zCrossRefPubMedPubMedCentral

16.

Monica Carissa T et al (2022) Long-term functional outcomes of patients with Hirschsprung disease following pull-through. BMC Pediatr 22(1):246. https://doi.org/10.1186/s12887-022-03301-6CrossRefPubMedPubMedCentral

17.

Liu Z, Zhang Y, Li S et al (2023) Long-term bowel function after single-stage transanal endorectal pull-through in neonatal patients with Hirschsprung disease. Pediatr Surg Int 39(1):255. https://doi.org/10.1007/s00383-023-05517-8CrossRefPubMed

18.

Koo F, Chan M, King SK et al (2023) The early years: Hirschsprung disease and health-related quality of life. Qual Life Res 32(12):3327–3337. https://doi.org/10.1007/s11136-023-03482-2CrossRefPubMed

19.

Yamashita Y, Shirabe K, Tsuijita E et al (2013) Third or more repeat hepatectomy for recurrent hepatocellular carcinoma. Surgery 154(5):1038–1045. https://doi.org/10.1016/j.surg.2013.04.046CrossRefPubMed

20.

Zhang X, Sun D, Xu Q et al (2023) Risk factors for Hirschsprung disease-associated enterocolitis: a systematic review and meta-analysis. Int J Surg 109(8):2509–2524. https://doi.org/10.1097/JS9.0000000000000473CrossRefPubMedPubMedCentral

21.

Rosso M, Fremion E, Santoro SL et al (2020) Down syndrome disintegrative disorder: a clinical regression syndrome of increasing importance. Pediatrics 145(6):e20192939. https://doi.org/10.1542/peds.2019-2939CrossRefPubMed

22.

Wang D, Zhu T, Zhu L et al (2023) Screening of undernutrition in children with Hirschsprung disease using preoperative anthropometric parameters: a multicenter cross-sectional study. JPEN J Parenter Enteral Nutr 47(1):151–158. https://doi.org/10.1002/jpen.2440CrossRefPubMed

23.

Bechard LJ, Rothpletz-Puglia P, Touger-Decker R et al (2013) Influence of obesity on clinical outcomes in hospitalized children: a systematic review. JAMA Pediatr 167(5):476–482. https://doi.org/10.1001/jamapediatrics.2013.13CrossRefPubMedPubMedCentral

24.

Conrey PE, Denu L, O’Boyle KC et al (2023) IgA deficiency destabilizes homeostasis toward intestinal microbes and increases systemic immune dysregulation. Sci Immunol. https://doi.org/10.1126/sciimmunol.ade2335CrossRefPubMed

25.

Sun H, Bi J, Lei Q et al (2018) Partial enteral nutrition increases intestinal sIgA levels in mice undergoing parenteral nutrition in a dose-dependent manner. Int J Surg 49:74–79. https://doi.org/10.1016/j.ijsu.2017.12.011CrossRefPubMed

26.

Jiao CL, Chen XY, Feng JX (2016) Novel insights into the pathogenesis of Hirschsprung’s-associated enterocolitis. Chin Med J (Engl) 129(12):1491–1497. https://doi.org/10.4103/0366-6999.183433CrossRefPubMed

27.

Parahita IG, Makhmudi A, Gunadi. (2018) Comparison of Hirschsprung-associated enterocolitis following soave and Duhamel procedures. J Pediatr Surg. https://doi.org/10.1016/j.jpedsurg.2017.07.010CrossRefPubMed

28.

Xie C, Yan J, Zhang Z et al (2022) Risk factors for Hirschsprung-associated enterocolitis following soave: a retrospective study over a decade. BMC Pediatr 22(1):654. https://doi.org/10.1186/s12887-022-03692-6CrossRefPubMedPubMedCentral

29.

Taylor MA, Bucher BT, Reeder RW et al (2021) Comparison of Hirschsprung disease characteristics between those with a history of postoperative enterocolitis and those without: results from the pediatric colorectal and pelvic learning consortium. Eur J Pediatr Surg 31(3):207–213. https://doi.org/10.1055/s-0040-1716876CrossRefPubMed

30.

Le-Nguyen A, Righini-Grunder F, Piché N et al (2019) Factors influencing the incidence of Hirschsprung associated enterocolitis (HAEC). J Pediatr Surg 54(5):959–963. https://doi.org/10.1016/j.jpedsurg.2019.01.026CrossRefPubMed

31.

Zhang GW, Lin JH, Qian JP et al (2014) Analyzing risk factors for early postoperative bile leakage based on Clavien classification in bile duct stones. Int J Surg 12(8):757–761. https://doi.org/10.1016/j.ijsu.2014.05.079CrossRefPubMed

32.

Rohit A, Kirkham R, McCarthy L et al (2021) Exploring differences in perceptions of child feeding practices between parents and health care professionals: a qualitative study. BMC Public Health 21(1):1449. https://doi.org/10.1186/s12889-021-11493-2CrossRefPubMedPubMedCentral

33.

Harvey L, Bryant-Waugh R, Watkins B et al (2015) Parental perceptions of childhood feeding problems. J Child Health Care 19(3):392–401. https://doi.org/10.1177/1367493513509422CrossRefPubMed

34.

Knaus ME, Pendola G, Srinivas S et al (2023) Social determinants of health and Hirschsprung-associated enterocolitis. J Pediatr Surg 58(8):1458–1462. https://doi.org/10.1016/j.jpedsurg.2022.09.039CrossRefPubMed

35.

Lardner DR, Dick BD, Crawford S (2010) The effects of parental presence in the postanesthetic care unit on children’s postoperative behavior: a prospective, randomized, controlled study. Anesth Analg 110(4):1102–1108. https://doi.org/10.1213/ANE.0b013e3181cccba8CrossRefPubMed

36.

Pastor AC, Osman F, Teitelbaum DH et al (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.2008.10.052CrossRefPubMed

37.

Frykman PK, Kim S, Wester T et al (2018) Critical evaluation of the Hirschsprung-associated enterocolitis (HAEC) score: a multicenter study of 116 children with Hirschsprung disease. J Pediatr Surg 53(4):708–717. https://doi.org/10.1016/j.jpedsurg.2017.07.009CrossRefPubMed

Titel: Clinical characteristics and influence of postoperative Hirschsprung-associated enterocolitis: retrospective study at a tertiary children’s hospital
verfasst von: Wei Feng
Bobin Zhang
Linxiao Fan
Aohua Song
Jinping Hou
Xiaohong Die
Wei Liu
Yi Wang
Zhenhua Guo
Publikationsdatum: 01.12.2024
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Surgery International / Ausgabe 1/2024
Print ISSN: 0179-0358
Elektronische ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-024-05688-y

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Clinical characteristics and influence of postoperative Hirschsprung-associated enterocolitis: retrospective study at a tertiary children’s hospital