Department of Pediatric Surgery, Miyagi Children's Hospital, Sendai, 989-3126, Japan.
Pediatr Surg Int. 2021 Feb;37(2):275-280. doi: 10.1007/s00383-020-04784-z. Epub 2020 Nov 27.
The risk factors for postoperative Hirschsprung-associated enterocolitis (HAEC) are still incompletely understood, especially age at which surgery is performed. Therefore, the aim of this study was to identify the risk factors for the development of postoperative HAEC in children operated during infancy.
Thirty-five children who had undergone radical surgery for Hirschsprung disease (HD) during infancy were included in the study. They were divided into two groups; those who developed postoperative HAEC (HAEC, 14 patients) and those who did not (no HAEC, 21 patients). Their medical records were retrospectively reviewed for clinical details.
Developing postoperative HAEC was significantly associated with long-segment HD (p = 0.020) and the age at radical surgery (p = 0.0241). No other factors had a significant association with postoperative HAEC. In the patients who developed postoperative HAEC (n = 14), those with Trisomy 21 had significantly longer hospitalizations than those without. Patients with long-segment HD had a higher hospitalization rate than those with short-segment HD.
This study clearly showed that long-segment HD and older age at radical surgery are risk factors for developing postoperative HAEC.
术后巨结肠相关性肠炎（HAEC）的危险因素仍不完全清楚，尤其是手术时的年龄。因此，本研究旨在确定婴儿期接受根治性手术治疗的儿童术后发生 HAEC 的危险因素。
本研究纳入 35 例接受根治性巨结肠手术的婴儿。将其分为术后发生 HAEC（HAEC，14 例）和未发生 HAEC（无 HAEC，21 例）两组。回顾性分析其临床资料。
术后发生 HAEC 与长段型 HD（p=0.020）和根治手术时的年龄（p=0.0241）显著相关。其他因素与术后 HAEC 无显著相关性。在发生术后 HAEC 的患者（n=14）中，21 三体患者的住院时间明显长于无 21 三体患者。长段型 HD 患者的住院率高于短段型 HD 患者。
本研究清楚地表明，长段型 HD 和根治手术时年龄较大是发生术后 HAEC 的危险因素。
