嗜酸粒细胞和淋巴细胞增多与经腹 Yancey-Soave 拖出术治疗先天性巨结肠病患者的功能结局的关系。

Association between eosinophilia and lymphocytosis with functional outcomes of patients with Hirschsprung disease following transabdominal Yancey-Soave pull-through.

机构信息

Universitas Gadjah Mada/Dr. Sardjito Hospital, Faculty of Medicine, Public Health and Nursing, Department of Surgery, Pediatric Surgery Division, Yogyakarta, Indonesia.

Universitas Gadjah Mada/Dr. Sardjito Hospital, Faculty of Medicine, Public Health and Nursing, Department of Clinical Pathology and Laboratory Medicine, Yogyakarta, Indonesia.

出版信息

Med J Malaysia. 2024 Aug;79(Suppl 4):6-11.

PMID:39215408

Abstract

INTRODUCTION

Hirschsprung disease (HSCR) is a disorder caused by the failure of neural crest migration leading to an aganglionic colon and functional obstruction. Transabdominal Yancey-Soave pull-through is one of the definitive therapies for this condition. Prognostic factors, including sex, aganglionosis type, age at definitive surgery, nutritional status, eosinophilia and lymphocytosis, might influence the outcomes of the pull-through. We evaluated the functional outcomes of HSCR patients after Yancey- Soave surgery and associated them with the prognostic factors.

MATERIALS AND METHODS

The study included Hirschsprung patients aged ≥3 and <18 years who underwent Yancey- Soave surgery at our hospital. The functional outcomes were evaluated using the Krickenbeck classification to determine voluntary bowel movement (VBM), constipation and soiling.

RESULTS

Most (82.6%) patients showed VBM, 26.1% had constipation and 4.3% suffered from soiling. Among 23 patients who received Yancey-Soave surgery, 8 (34.8%) had eosinophilia and 5 (21.7%) had lymphocytosis. However, no significant differences were observed between eosinophilia and non-eosinophilia groups for VBM (p=1.0), constipation (p= 0.621) or soiling (p=0.738). Similarly, no significant differences were found between lymphocytosis and nonlymphocytosis groups for VBM (p=1.0), constipation (p=0.545) or soiling (p=0.973). Moreover, no other prognostic factors affected the functional outcomes after Yancey- Soave surgery (p>0.05).

CONCLUSION

Our study shows that eosinophilia and lymphocytosis might not affect the functional outcome of patients with HSCR following Yancey-Soave surgery. In addition, sex, aganglionosis type, age at definitive surgery and nutritional status might not influence the functional outcome after definitive surgery. Further, a more extensive study is essential to clarify our findings.

摘要

介绍

先天性巨结肠（HSCR）是一种由于神经嵴迁移失败导致无神经节的结肠和功能性梗阻的疾病。经腹 Yancey-Soave 拖出术是治疗该病的一种确定性治疗方法。预后因素，包括性别、无神经节细胞症类型、确定性手术时的年龄、营养状况、嗜酸性粒细胞增多和淋巴细胞增多，可能会影响拖出术的结果。我们评估了 HSCR 患者在接受 Yancey-Soave 手术后的功能结果，并将其与预后因素相关联。

材料和方法

本研究纳入了在我院接受 Yancey-Soave 手术的年龄≥3 岁且<18 岁的先天性巨结肠患者。使用 Krickenbeck 分类法评估功能结果，以确定自主排便（VBM）、便秘和粪便污染。

结果

大多数（82.6%）患者有 VBM，26.1%有便秘，4.3%有粪便污染。在接受 Yancey-Soave 手术的 23 名患者中，8 名（34.8%）有嗜酸性粒细胞增多，5 名（21.7%）有淋巴细胞增多。然而，嗜酸性粒细胞增多组与非嗜酸性粒细胞增多组在 VBM（p=1.0）、便秘（p=0.621）或粪便污染（p=0.738）方面无显著差异。同样，淋巴细胞增多组与非淋巴细胞增多组在 VBM（p=1.0）、便秘（p=0.545）或粪便污染（p=0.973）方面也无显著差异。此外，其他预后因素对 Yancey-Soave 手术后的功能结果无影响（p>0.05）。