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, 2021 Jun.
Article
em En
| MEDLINE
| ID: mdl-32947626
ABSTRACT
INTRODUCTION:
The current understanding of Hirschsprung-associated enterocolitis (HAEC) is based mainly on single-center, retrospective studies. The aims of this study are to determine risk factors for postoperative HAEC using the Pediatric Colorectal and Pelvic Learning Consortium (PCPLC) database. MATERIALS ANDMETHODS:
We performed a multicenter, retrospective, case-control study of children with Hirschsprung disease (HD) who had undergone a pull-through procedure and were evaluated at a PCPLC member site between February 2017 and March 2020. The cohort with a history of postoperative HAEC was compared with that without postoperative episodes of HAEC to determine relevant associations with postoperative HAEC.RESULTS:
One-hundred forty of 299 (46.8%) patients enrolled had a history of postoperative HAEC. Patients with a rectosigmoid transition zone had a lower association with postoperative HAEC as compared with those with a more proximal transition zone (odds ratio [OR] 0.46, 95% confidence interval [CI] 0.26, 0.84, p < 0.01). Private insurance was protective against postoperative HAEC on univariate analysis (OR 0.62, 95% CI 0.38, 0.99, p = 0.047), but not on multivariate analysis (OR 0.62, 95% CI 0.37, 1.04, p = 0.07). Preoperative HAEC was not associated with the development of postoperative HAEC.CONCLUSION:
Patients with a rectosigmoid transition zone have less postoperative HAEC compared with patients with a more proximal transition zone. Multi-institutional collection of clinical information in patients with HD may allow for the identification of additional risk factors for HAEC and afford the opportunity to improve care.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
/
Procedimentos Cirúrgicos do Sistema Digestório
/
Enterocolite
/
Doença de Hirschsprung
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Adult
/
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
/
Newborn
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article