Comprehensive Colorectal Center, Section of Colorectal and Pelvic Reconstructive Surgery, Department of Pediatric Surgery, Children's Mercy Kansas City, Kansas City, MO, 64108, USA; Department of Surgery, University of Missouri-Kansas City, Kansas City, MO, 64108, USA.
Comprehensive Colorectal Center, Section of Colorectal and Pelvic Reconstructive Surgery, Department of Pediatric Surgery, Children's Mercy Kansas City, Kansas City, MO, 64108, USA.
J Pediatr Surg. 2024 Nov;59(11):161677. doi: 10.1016/j.jpedsurg.2024.08.017. Epub 2024 Aug 10.
Children with total colonic Hirschsprung disease (TCHD) are a unique group of patients with pre- and postoperative management challenges. This review provides a rational, expert-based approach to diagnosing and managing TCHD.
The guidelines were developed by the Hirschsprung Disease Interest Group members established by the American Pediatric Surgical Association (APSA) Board of Governors. Group discussions, literature review, and expert consensus were used to summarize the current knowledge regarding diagnosis, staged approach, the timing of pull-through, and pre-and postoperative management in children with TCHD.
This paper presents recommendations for managing TCHD before and after reconstruction, including diagnostic criteria, surgical approaches, bowel management, diet, antibiotic prophylaxis, colonic irrigations, and post-surgical considerations.
A clear understanding of the unique challenges posed by TCHD and consensus on its treatment are lacking in the literature. This review standardizes this patient group's pre- and postoperative management.
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患有全结肠先天性巨结肠（TCHD）的儿童是一组具有特殊术前和术后管理挑战的患者。本综述提供了一种合理的、基于专家意见的方法来诊断和管理 TCHD。
该指南由美国儿外科协会（APSA）理事会设立的先天性巨结肠病兴趣小组成员制定。通过小组讨论、文献回顾和专家共识，总结了目前关于 TCHD 诊断、分期方法、拖出时间以及术前和术后管理的知识。
本文提出了 TCHD 重建前后的管理建议，包括诊断标准、手术方法、肠道管理、饮食、抗生素预防、结肠灌洗和术后注意事项。
文献中对 TCHD 带来的独特挑战缺乏明确的认识和共识，本综述使该患者群体的术前和术后管理标准化。
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