The Prevalence and Clinical Impact of Transition Zone Anastomosis in Hirschsprung Disease: A Systematic Review and Meta-Analysis
| Autor: | Hosnieya Labib, Daniëlle Roorda, J. Patrick van der Voorn, Jaap Oosterlaan, L. W. Ernest van Heurn, Joep P. M. Derikx |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2023 |
| Předmět: | |
| Zdroj: | Children, Vol 10, Iss 9, p 1475 (2023) |
| Druh dokumentu: | article |
| ISSN: | 10091475 2227-9067 |
| DOI: | 10.3390/children10091475 |
| Popis: | Background: Hirschsprung disease (HD) is characterized by absent neuronal innervation of the distal colonic bowel wall and is surgically treated by removing the affected bowel segment via pull-through surgery (PT). Incomplete removal of the affected segment is called transition zone anastomosis (TZA). The current systematic review aims to provide a comprehensive overview of the prevalence and clinical impact of TZA. Methods: Pubmed, Embase, Cinahl, and Web of Sciences were searched (last search: October 2020), and studies describing histopathological examination for TZA in patients with HD were included. Data were synthesized into aggregated Event Rates (ER) of TZA using random-effects meta-analysis. The clinical impact was defined in terms of obstructive defecation problems, enterocolitis, soiling, incontinence, and the need for additional surgical procedures. The quality of studies was assessed using the Newcastle–Ottawa Scale. Key Results: This systematic review included 34 studies, representing 2207 patients. After excluding series composed of only patients undergoing redo PT, the prevalence was 9% (ER = 0.09, 95% CI = 0.05–0.14, p < 0.001, I2 = 86%). TZA occurred more often after operation techniques other than Duhamel (X2 = 19.21, p = 2 = 7.26, p = 0.007). Conclusions and Inferences: TZA is associated with obstructive defecation problems and redo PT and is thus necessary to prevent. |
| Databáze: | Directory of Open Access Journals |
| Externí odkaz: |
|