| Autor: |
Lea A. Wehrli, Marina L. Reppucci, Jenny Stevens, Michael Arnold, Mark Lovell, María Zornoza, Andrea Bischoff, Luis De la Torre |
| Jazyk: |
angličtina |
| Rok vydání: |
2023 |
| Předmět: |
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| Zdroj: |
Journal of Pediatric Surgery Open, Vol 3, Iss , Pp 100058- (2023) |
| Druh dokumentu: |
article |
| ISSN: |
2949-7116 |
| DOI: |
10.1016/j.yjpso.2023.100058 |
| Popis: |
Background: In Patients with Hirschsprung Disease (HSCR) suffering from obstructive symptoms after their pull-through surgery, a transition zone pull-through (TZPT) was suggested as a causing factor. Current guidelines recommend a reoperation resecting the transition zone in these patients. This present study reports the clinical outcomes in patients with a confirmed TZPT. Methods: A retrospective review of patients who underwent a primary transanal pull-through for recto-sigmoid HSCR at the Children's Hospital Colorado from January 2010 until June 2020 was performed. We included patients with a TZPT confirmed on the definitive histopathological report of the proximal margin's circumference obtained at the time of their pull-through surgery and follow-up at the Children's Hospital Colorado. Demographic data were collected. The primary outcome of interest was fecal control, episodes of Hirschsprung-associated enterocolitis (HAEC), the necessity of bowel management (with either laxatives or enemas), and a redo pull-through. Results: Six patients had a TZPT. Two patients suffered episodes of HAEC. One patient is fecal incontinent. None of them underwent redo pull-through surgery. Medical treatment was successful in all with obstructive symptoms. Conclusion: Patients who underwent a pull-through surgery for HSCR with retained transition zone may suffer from obstructive symptoms, which can be managed conservatively with medical treatment. A TZPT is not necessarily associated with persistent obstructive symptoms. Level of evidence/type of study: Level III, retrospective. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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