Universitas Gadjah Mada, Public Health and Nursing, Faculty of Medicine, Department of Surgery, Pediatric Surgery Division, Yogyakarta, Indonesia.
Universitas Gadjah Mada, Public Health and Nursing, Faculty of Medicine, Laboratory of Bioanthropology and Paleoanthropology, Yogyakarta, Indonesia.
Med J Malaysia. 2020 May;75(Suppl 1):28-31.
Despite various definitive methods that are used for treating Hirschsprung's disease (HSCR), there are few studies comparing the effect of different pull-through methods on the growth outcomes of patients. We aimed to compare the effect of three different pull-through methods, namely Duhamel, Soave and transanal endorectal pullthrough (TEPT), on HSCR growth outcomes of patients.
Medical records of all HSCR patients who underwent pull-through at the Dr. Sardjito Hospital, Indonesia between January 2010 and August 2016 were reviewed for their growth outcomes before and after the surgery.
We included 64 HSCR patients, 45 males and 19 females, of which 14, 17, and 33 patients underwent Duhamel, Soave, and TEPT respectively. There were no nutritional status differences in HSCR patients after Duhamel, Soave, and TEPT surgery (p=0.07, 0.17, and 0.79, respectively). Z-score average of weight-for-age did not differ between three surgical methods (p=0.77 and 0.15 for preoperative and postoperative, respectively). In addition, the improvement of nutritional status was achieved in 21.2% HSCR patients after TEPT, 14.3% post Duhamel and 5.9% following Soave procedure, but these differences did not reach a significant level (p=0.34).
Our study shows no difference in effect on the growth outcomes in HSCR patients following Duhamel, Soave and TEPT procedure. Further study with a larger sample size is important to give valuable long-term growth outcomes for HSCR patients after pull-through.
尽管有多种明确的方法可用于治疗先天性巨结肠（HSCR），但比较不同拖出方法对患者生长结果影响的研究较少。我们旨在比较三种不同拖出方法（Duhamel、Soave 和经肛门直肠内拖出术（TEPT））对 HSCR 患者生长结果的影响。
回顾 2010 年 1 月至 2016 年 8 月期间在印度尼西亚 Sardjito 医院接受拖出术的所有 HSCR 患者的病历，以评估手术前后的生长结果。
我们纳入了 64 名 HSCR 患者，男性 45 名，女性 19 名，其中 14 名、17 名和 33 名患者分别接受了 Duhamel、Soave 和 TEPT 手术。Duhamel、Soave 和 TEPT 手术后 HSCR 患者的营养状况无差异（p=0.07、0.17 和 0.79）。三种手术方法的体重与年龄的 Z 评分平均值无差异（术前分别为 p=0.77 和 0.15，术后分别为 p=0.77 和 0.15）。此外，TEPT 后有 21.2%的 HSCR 患者营养状况得到改善，Duhamel 后有 14.3%，Soave 后有 5.9%，但这些差异无统计学意义（p=0.34）。
我们的研究表明，Duhamel、Soave 和 TEPT 手术对 HSCR 患者的生长结果影响无差异。进一步的研究需要更大的样本量，以提供 HSCR 患者拖出术后有价值的长期生长结果。
