The association between short-term postoperative complications and bowel function after surgery for Hirschsprung disease.

OBJECTIVE

This study aims to investigate the relationship between postoperative short-term complications and bowel function in patients with Hirschsprung disease (HSCR), and to explore the risk factors affecting bowel function.

METHODS

The medical records of 367 eligible patients diagnosed with HSCR were reviewed. According to the bowel function score (BFS), patients were divided into a normal bowel function group (200 cases, BFS > 17) and an abnormal bowel function group (167 cases, BFS ≤ 17), and the possible risk factors for poor bowel function were evaluated through univariate and multivariate analysis. According to the Clavien Madadi (CM) classification of complications, CM grades I and II were considered mild complications and CM III and IV were considered severe complications.

RESULTS

According to binary logistic regression analysis, long-segment disease (OR = 3.255; 95% CI, 1.192-9.655; p = 0.026), formula feeding (OR = 3.081; 95% CI, 1.626-5.933; p = 0.001), mild complications (OR = 9.560; 95% CI, 4.261-24.01; p < 0.001), and severe complications (OR = 17.127; 95% CI, 4.280-116.6; p < 0.001) were independent risk factors for postoperative poor bowel function. The surgery age between 1 and 3 years (OR = 0.357; 95% CI, 0.158-0.791; p = 0.012) was associated with a reduction in the incidence of poor bowel function.

CONCLUSIONS

Postoperative complications, long-segment disease, and formula feeding are independent risk factors for postoperative poor bowel function in patients with HSCR. Further multicenter studies require larger sample sizes to clarify and confirm our findings.