Lindert Judith, Schulze Felix, Märzheuser Stefanie
Department of Paediatric Surgery, Paediatric Colorectal Center Rostock, University Hospital Rostock, Ernst-Heydemann Str. 8, 18057 Rostock, Germany.
Children (Basel). 2024 May 13;11(5):588. doi: 10.3390/children11050588.
(1) Background: Bowel management contributes throughout the pathway of care for children with Hirschsprung. Preoperative bowel management prepares the child and family for the pull-through surgery. Perioperative bowel management supports early recovery and tailored bowel management in the follow-up supports the achievement of social continence. (2) Methods: We conducted a cross-sectional assessment of our institutional bowel management program to illustrate the pre-, peri- and postoperative bowel management strategies. (3) Results: A total of 31 children underwent primary pull-through, 23 without a stoma and 8 with a stoma, at a median age of 9 months. All children without a stoma were prepared for surgery by using rectal irrigations. Children with a stoma were prepared for surgery with a transfer of stoma effluent. Transanal irrigation supported early recovery. (4) Conclusions: Bowel management is a key pillar of the management of children with Hirschsprung disease. Incorporating bowel management in the pathway of care facilitates primary pull-through and supports perioperative recovery.
(1) 背景：肠道管理贯穿先天性巨结肠患儿的整个护理过程。术前肠道管理为患儿及其家庭接受拖出式手术做好准备。围手术期肠道管理有助于早期恢复，而后续的个性化肠道管理则有助于实现社会控便。(2) 方法：我们对本机构的肠道管理项目进行了横断面评估，以阐明术前、围手术期和术后的肠道管理策略。(3) 结果：共有31例患儿接受了初次拖出式手术，其中23例未行造口术，8例行了造口术，中位年龄为9个月。所有未行造口术的患儿均通过直肠灌洗为手术做准备。行造口术的患儿通过造口排泄物转流为手术做准备。经肛门灌洗有助于早期恢复。(4) 结论：肠道管理是先天性巨结肠病患儿管理的关键支柱。将肠道管理纳入护理过程有助于初次拖出式手术，并支持围手术期恢复。
